Clinical outcomes of cap-assisted endoscopic resection for small rectal subepithelial tumors |
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Authors: | Jing Wang Shiyong Lin Weiguang Qiao Side Liu Fachao Zhi |
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Institution: | 1. Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangdong Provincial Key Laboratory of Gastroenterology, Inst. of Gastroenterology of Guangdong Province, Guangzhou 510515, PR China;2. Department of Endoscopy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, PR China;3. Section One of Department of Internal Medicine, People''s Hospital of Linzhi City, Nyingchi, Tibet 860000, PR China |
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Abstract: | ObjectiveTo assess the effectiveness and safety of cap-assisted endoscopic resection and the usefulness of endoscopic ultrasonography (EUS) for managing small rectal subepithelial tumors (SETs).Patients and methodsPatients with small rectal SETs ≤ 10 mm in diameter were enrolled in this study at our hospital from October 2014 to December 2017. First, EUS was performed to evaluate the lesions. Then, cap-assisted endoscopic resection was performed by suctioning the SET into a transparent cap, ligating with a metal snare and then resecting the tumor. The wound was closed using endoclips if necessary.ResultsForty patients were enrolled in the study. EUS showed lesions originating from muscularis mucosa or submucosa with an average diameter of 5.4 × 3.1 mm. The en bloc resection rate was 85.0% obtained by cap-assisted endoscopic resection, with a mean total procedure time of 17.6 min. No immediate perforation happened. Immediate bleeding occurred in five patients; all cases were managed successfully by endoscopy. No delayed bleeding was observed. Pathology examination showed that 70.0% of the lesions were neuroendocrine tumors (G1). One case of recurrence was seen in follow-up; it was managed successfully by endoscopic submucosal dissection. There was no tumor recurrence in a median follow-up period of 41 months in the remaining 39 patients.ConclusionsMost small rectal SETs arising from the muscularis mucosa or submucosa are neuroendocrine tumors and require proper treatment. Cap-assisted endoscopic resection is simple, effective and safe for resecting such lesions, and EUS is useful for case screening. |
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Keywords: | Rectal subepithelial tumor Cap-assisted endoscopic resection Endoscopic ultrasonography Tumor subepitelial rectal Resección endoscópica asistida por capuchón Ultrasonografía endoscópica |
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