Safety and Efficacy of Simplified EMR Versus ESD for Rectal Neuroendocrine Tumors ≤ 10 Mm: A Retrospective Cohort Study

作者：Linfeng Zou, Long Zou, Yingyun Yang, Weixun Zhou, Xi Wu, Tao Guo, Qingwei Jiang, Yunlu Feng, Shengyu Zhang, Qiang Wang, Aiming Yang · 发表于：Journal of Clinical Medicine · 年份：2025 · DOI：10.3390/jcm14176125 · 被引用次数：3 · 研究领域：Neuroendocrine Tumor Research Advances、Gastric Cancer Management and Outcomes、Gastrointestinal Tumor Research and Treatment

Background: Rectal neuroendocrine tumors (NETs) ≤ 10 mm are commonly managed by endoscopic resection. However, the optimal technique remains controversial. We aimed to compare the efficacy and safety of a simplified endoscopic mucosal resection (sEMR) technique, performed without submucosal injection, with conventional endoscopic submucosal dissection (ESD) for small rectal NETs. Methods: This retrospective, single-center study included 74 patients with histologically confirmed rectal NETs ≤ 10 mm treated with sEMR (n = 37) or ESD (n = 37) between January 2022 and January 2025. Patients in the ESD group were matched 1:1 by age and gender. Baseline characteristics, procedural outcomes, histopathologic findings, and cost were analyzed. The primary outcome was histological complete resection (R0) rate; secondary outcomes included en bloc resection, intraoperative bleeding, tumor-to-margin distance, operation time, and material costs. Results: The R0 resection rate was significantly higher in the sEMR group compared to the ESD group (91.9% vs. 67.6%; p = 0.019). Tumor-to-margin distance was also significantly greater in the sEMR group [median (IQR): 0.2 (0.1–0.3) mm vs. 0.1 (0–0.2) mm; p = 0.024]. Intraoperative bleeding was less frequent in the sEMR group (2.7% vs. 21.6%; p = 0.028). Median operation time (409 vs. 1469 s; p < 0.001) and material cost (1486 vs. 6390 CNY; p < 0.001) were both significantly lower in the sEMR group. Conclusions: Compared with ESD, the simplifi...