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CC BY 4.0 · Endosc Int Open 2025; 13: a25499852
DOI: 10.1055/a-2549-9852
Original article

Endoscopic intermuscular dissection for management of 10- to 20-mm rectal neuroendocrine tumors: Pilot study (with video)

Authors

  • Silin Huang

    1   Gastroenterology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China

  • Bo Li

    1   Gastroenterology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China

  • Huizhao Deng

    2   Nephrology and Rheumatology, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Shenzhen, China

  • Guang Yang

    1   Gastroenterology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China

  • Ronggang Zhang

    1   Gastroenterology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China

  • Jianzhen Ren

    1   Gastroenterology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China

  • Nan Liu

    3   Institute of Environment and Health, South China Hospital, Shenzhen University, Shenzhen, China
    4   Marshall Laboratory of Biomedical Engineering, Shenzhen University, Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China

  • Suhuan Liao

    1   Gastroenterology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China
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Abstract

Background and study aims

Endoscopic intermuscular dissection (EID) is associated with higher rates of negative margins in treating rectal neuroendocrine tumors (R-NETs), as reported in case studies. However, evidence regarding the safety and effectiveness of EID remains insufficient. This study aimed to evaluate clinical safety and effectiveness of EID in treating 10- to 20-mm R-NETs.

Patients and methods

Retrospective clinical data from patients with 10- to 20-mm R-NETs who had undergone EID from 2019 to 2024 were collected from a tertiary hospital. The primary outcome was the histological complete resection rate and secondary outcomes included en bloc resection rate and technical success rate.

Results

Twelve patients who had undergone EID were included, with one patient excluded for pathology indicative of a leiomyoma. Among the 11 patients (mean age, 42.45 years; 72.73% males), median diameter was 11.55 mm (interquartile range 10–13 mm). All patients underwent en bloc resection and postoperative pathology confirmed negative horizontal and vertical margins, achieving a histological complete resection rate of 100%. Mean procedure time was 58.55 minutes (standard deviation [SD] 13.66 minutes) and mean postoperative hospital stay was 5.7 days (SD 1.00). One patient developed fever and another experienced abdominal pain, both of which resolved within 24 hours. There were no cases of bleeding or perforation intraoperatively or postoperatively. During a mean follow-up of 31.73 months, there were no residual tumors, local recurrences, or metastases.

Conclusions

EID is a promising treatment for 10- to 20-mm R-NETs, with high initial cure rates, and a new option for endoscopic resection. More studies of the procedure are needed.

Keywords

Endoscopy Lower GI Tract - Endoscopic resection (polypectomy, ESD, EMRc, ...) - Tissue diagnosis - Polyps / adenomas / ...


Publikationsverlauf

Eingereicht: 18. November 2024

Angenommen nach Revision: 24. Februar 2025

Artikel online veröffentlicht:
04. April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Silin Huang, Bo Li, Huizhao Deng, Guang Yang, Ronggang Zhang, Jianzhen Ren, Nan Liu, Suhuan Liao. Endoscopic intermuscular dissection for management of 10- to 20-mm rectal neuroendocrine tumors: Pilot study (with video). Endosc Int Open 2025; 13: a25499852.
DOI: 10.1055/a-2549-9852
 

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