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Endoscopic mucosal resection using anchored snare Tip-in versus precut technique for small rectal neuroendocrine tumors

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Author(s)
Seung Wook HongDong-Hoon YangYoo Jin LeeDong Hoon BaekJaeyoung ChunHyun Gun KimSung Joo KimSeung-Mo HongDae-Seong Myung
Keimyung Author(s)
Lee, Yoo Jin
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean J Intern Med
Issued Date
2024
Volume
39
Issue
2
Keyword
Endoscopic mucosal resectionMulticenter studyNeuroendocrine tumorsRandomized controlled trial
Abstract
Background/aims:
Small rectal neuroendocrine tumors (NETs) can be treated with modified endoscopic mucosal resection (EMR). However, an optimal EMR method remains to be established. We aimed to assess the non-inferiority of Tip-in EMR versus precut EMR (EMR-P) for treating rectal NETs.

Methods:
This prospective, multicenter, randomized controlled trial enrolled patients with rectal NETs of < 10 mm in diameter. The patients were randomly assigned to EMR-P and Tip-in EMR groups in a 1:1 ratio. Primary outcome was margin-negative (R0) resection rate between the two methods, with a noninferiority margin of 10%.

Results:
Seventy-five NETs in 73 patients, including 64 eligible lesions (32 lesions in each, EMR-P and Tip-in EMR groups), were evaluated. In a modified intention-to-treat analysis, R0 resection rates of the EMR-P and Tip-in EMR groups were 96.9% and 90.6%, respectively, which did not demonstrate non-inferiority (risk difference, -6.3 [95% confidence interval: -18.0 to 5.5]). Resection time in the EMR-P group was longer than that in the Tip-in EMR group (p < 0.001). One case of intraprocedural bleeding was reported in each group.

Conclusion:
We did not demonstrate the non-inferiority of Tip-in EMR compared to EMR-P for treating small rectal NETs. However, the R0 resection rates for both techniques were high enough for clinical application.
Keimyung Author(s)(Kor)
이유진
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2005-6648
Source
https://kjim.org/journal/view.php?doi=10.3904/kjim.2023.263
DOI
10.3904/kjim.2023.263
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45535
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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