Treatment of rectal neuroendocrine tumors by transanal endoscopic microsurgery

doi:10.3877/cma.j.issn.1674-6899.2016.04.003

Abstract

Abstract:

Objective

To assess the efficacy of full-thickness excision using transanal endoscopic microsurgery (TEM) in the treatment of rectal neuroendocrine tumors.

Methods

We analyzed the data of seventy four rectal neuroendocrine tumor patients who underwent TEM between Dec.2006 and Dec. 2015 at our department. Data collected included patient demographics, tumor characteristics, operative details, postoperative outcomes, pathologic findings, and follow-ups.

Results

TEM was performed as a primary excision (n=50) or as complete surgery after incomplete resection by endoscopic polypectomy (n=24). The mean size of the primary tumor was (1.02 ± 0.43)cm, and the mean distance of the tumor from the anal verge was (7.9 ± 1.7)cm. The mean duration of the operation was (58.7 ± 12.1)min, and the mean blood loss was (13.1 ± 5.0)ml. Histopathologically, all tumors showed typical histology, and both deep and lateralsurgical margins were completely free of tumors.No recurrence was noted during the median of 3.6 years′ follow-up.

Conclusions

Full-thickness excision using TEM could be a first surgical option for complete removal of middle-upper small rectal neuroendocrine tumors.

Key words: Transanal endoscopic microsurgery, Rectal neuroendocrine tumor, Full-thickness excision

Junyang Lu, Guole Lin, Huizhong Qiu. Treatment of rectal neuroendocrine tumors by transanal endoscopic microsurgery[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2016, 09(04): 200-203.

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URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2016.04.003

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2016/V09/I04/200

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组别	例数	男性/女性(例数)	年龄(岁)	肿瘤大小(cm)	位置(前壁/后壁) (例数)	距离肛缘(cm)
初次手术组	50	26/24	51.2(24～70)	1.11±0.48	19/31	7.7±1.6
二次手术组	24	13/11	52.3(35～76)	0.84±0.23	10/14	8.4±1.8
P值		0.861	0.234	0.031	0.762	0.772

组别	例数	男性/女性(例数)	年龄(岁)	肿瘤大小(cm)	位置(前壁/后壁) (例数)	距离肛缘(cm)
初次手术组	50	26/24	51.2(24～70)	1.11±0.48	19/31	7.7±1.6
二次手术组	24	13/11	52.3(35～76)	0.84±0.23	10/14	8.4±1.8
P值		0.861	0.234	0.031	0.762	0.772

组别	例数	手术时间(min)	术中出血量(ml)	住院时间(d)	切除标本大小(cm)	浸润深度(黏膜/黏膜下/肌层)(例数)	肿瘤分级(G1级/G2级)(例数)
初次手术组	50	60.1±9.9	13.0±5.0	3.3±1.8	2.3±0.6	30/14/6	38/12
二次手术组	24	54.8±15.3	13.5±5.4	3.0±1.2	2.3±0.5	4/6/0	8/2
P值	?	0.122	0.530	0.083	0.562	－	－

组别	例数	手术时间(min)	术中出血量(ml)	住院时间(d)	切除标本大小(cm)	浸润深度(黏膜/黏膜下/肌层)(例数)	肿瘤分级(G1级/G2级)(例数)
初次手术组	50	60.1±9.9	13.0±5.0	3.3±1.8	2.3±0.6	30/14/6	38/12
二次手术组	24	54.8±15.3	13.5±5.4	3.0±1.2	2.3±0.5	4/6/0	8/2
P值	?	0.122	0.530	0.083	0.562	－	－

[1]	Lin Shi, Yanmin Wang, Si Xiong. Clinical analysis of local excision for rectal stromal tumors in 39 cases [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(03): 297-299.
[2]	Xueshan Bai, Guole Lin, Xin Wu, Xiaoqiang Xue, Jiaolin Zhou, Huizhong Qiu. Transanal endoscopic microsurgery (TEM) for rare rectal tumors [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2019, 08(06): 580-587.
[3]	Xiaoqiang Xue, Guole Lin. Updates on the applications and indications of the technique of transanal endoscopic microsurgery [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2019, 08(02): 109-114.
[4]	Yin-gang CHEN, Li-jian XIA. Transanal endoscopic microsurgery for anorectal diseases [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2014, 03(05): 331-334.

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