Open Access Article
International Journal of Clinical Research. 2025; 9: (8) ; 181-184 ; DOI: 10.12208/j.ijcr.20250410.
A comparative study on the efficacy and safety of endoscopic mucosal resection and endoscopic submucosal dissection in the treatment of small rectal neuroendocrine tumors
内镜黏膜切除术与内镜黏膜下剥离术治疗小型直肠神经内分泌肿瘤的疗效与安全性对照研究
作者：
薛正青,
刘一威,
朱红梅,
应续芹,
秦淑满,
王玲玲 *
盐城市亭湖区人民医院消化科 江苏盐城
*通讯作者：
王玲玲,单位：盐城市亭湖区人民医院消化科 江苏盐城；
发布时间: 2025-08-31 总浏览量: 63
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摘要
目的 回顾性比较预切内镜黏膜切除术（EMR-P）与内镜黏膜下剥离术（ESD）治疗小型直肠神经内分泌肿瘤（NET）的有效性和安全性。方法 回顾2020年6月至2024年12月间盐城市亭湖区人民医院收治的58例小型直肠NET患者临床资料，比较EMR-P组与ESD组的整块切除率、病理完全切除率、根治性切除率、手术时间、不良事件发生率及住院时间。结果 EMR-P组手术时间显著短于ESD组（P< 0.05），中位住院时间亦显著短于ESD组（P< 0.05）。两组整块切除率、病理完全切除率及根治性切除率差异无统计学意义。两组不良事件发生率差异亦无统计学意义。两组患者经保守治疗后，迟发性出血及迟发性穿孔发生率均得到改善。EMR-P组与ESD组垂直切缘阳性率及水平切缘阳性率差异均无统计学意义。随访期间，两组患者均未观察到局部复发或转移。结论 EMR-P是一种有效且安全的内镜治疗方法，适用于直径≤10 mm的直肠NET。相较于ESD，EMR-P显著缩短手术时间和住院时间，且不增加切缘阳性率。
关键词： 直肠神经内分泌肿瘤；内镜黏膜切除术；内镜黏膜下剥离术
Abstract
Objective To retrospectively compare the efficacy and safety of precut endoscopic mucosal resection (EMR-P) and endoscopic submucosal dissection (ESD) in treating small rectal neuroendocrine tumors (NETs). Methods Clinical data of 58 patients with small rectal NETs admitted to Tinghu District People's Hospital of Yancheng City from June 2020 to December 2024 were reviewed. The en bloc resection rate, pathological complete resection rate, curative resection rate, operation time, adverse event rate, and hospitalization time were compared between the EMR-P and ESD groups. Results The operation time in the EMR-P group was significantly shorter than that in the ESD group (P<0.05), and the median hospitalization time was also significantly shorter (P< 0.05). There were no significant differences in en bloc resection rate, pathological complete resection rate, or curative resection rate between the two groups. The adverse event rates showed no significant differences. After conservative treatment, the rates of delayed bleeding and delayed perforation improved in both groups. No significant differences were observed in vertical or horizontal margin positivity rates between the EMR-P and ESD groups. No local recurrence or metastasis was observed during follow-up in either group. Conclusion EMR-P is an effective and safe endoscopic treatment for rectal NETs with a diameter ≤10 mm. Compared to ESD, EMR-P significantly shortens operation and hospitalization times without increasing margin positivity rates.
Key words： Rectal neuroendocrine tumors; Endoscopic mucosal resection; Endoscopic submucosal dissection
参考文献 References
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引用本文
薛正青, 刘一威, 朱红梅, 应续芹, 秦淑满, 王玲玲, 内镜黏膜切除术与内镜黏膜下剥离术治疗小型直肠神经内分泌肿瘤的疗效与安全性对照研究[J]. 国际临床研究杂志, 2025; 9: (8) : 181-184.