Buscar en
Gastroenterología y Hepatología (English Edition)
Toda la web
Inicio Gastroenterología y Hepatología (English Edition) Clinical outcomes of cap-assisted endoscopic resection for small rectal subepith...
Journal Information
Vol. 44. Issue 6.
Pages 418-423 (June - July 2021)
Share
Share
Download PDF
More article options
ePub
Visits
3
Vol. 44. Issue 6.
Pages 418-423 (June - July 2021)
Original Article
DOI: 10.1016/j.gastre.2020.08.011
Clinical outcomes of cap-assisted endoscopic resection for small rectal subepithelial tumors
Resultados clínicos de la resección endoscópica asistida por capuchón para pequeños tumores subepiteliales rectales
Visits
...
Jing Wanga,1, Shiyong Lina,b,c,1, Weiguang Qiaoa,
Corresponding author
qwg1991@126.com

Corresponding author.
, Side Liua, Fachao Zhia
a Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangdong Provincial Key Laboratory of Gastroenterology, Inst. of Gastroenterology of Guangdong Province, Guangzhou 510515, PR China
b 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
c Section One of Department of Internal Medicine, People's Hospital of Linzhi City, Nyingchi, Tibet 860000, PR China
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Tables (3)
Table 1. Patients’ characteristics and features of the tumors.
Table 2. Outcomes of patients treated by cap-assisted endoscopic resection.
Table 3. Characteristics of failed en bloc resection lesions.
Show moreShow less
Abstract
Objective

To 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 methods

Patients with small rectal SETs10mm 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.

Results

Forty patients were enrolled in the study. EUS showed lesions originating from muscularis mucosa or submucosa with an average diameter of 5.4×3.1mm. The en bloc resection rate was 85.0% obtained by cap-assisted endoscopic resection, with a mean total procedure time of 17.6min. 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.

Conclusions

Most 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.

Keywords:
Rectal subepithelial tumor
Cap-assisted endoscopic resection
Endoscopic ultrasonography
Resumen
Objetivo

Evaluar la eficacia y la seguridad de la resección endoscópica asistida por capuchón y la utilidad de la ultrasonografía endoscópica (USE) para el tratamiento de pequeños tumores subepiteliales (TSE) rectales.

Pacientes y métodos

Los pacientes con TSE rectales pequeños ≤10 mm de diámetro se enrolaron en este estudio en nuestro hospital desde octubre de 2014 hasta diciembre de 2017. Primero, se realizó una USE para evaluar las lesiones. Luego, se realizó una resección endoscópica asistida por capuchón aspirando el TSE en un capuchón transparente, ligándolo con una asa metálica de polipectomía y luego resecando el tumor. La herida se cerró usando endoclips, si ello era necesario.

Resultados

Cuarenta pacientes fueron enrolados en el estudio. La USE mostró lesiones originadas en la muscularis mucosae o submucosa con un diámetro promedio de 5,4 × 3,1 mm. La tasa de resección en bloque fue del 85,0% obtenida mediante resección endoscópica asistida por capuchón, con un tiempo total medio de procedimiento de 17,6 min. No se produjo ninguna perforación en el momento. Se produjo una hemorragia inmediata en cinco pacientes; todos los casos se trataron con éxito mediante una endoscopia. No se observó ningún retraso en el sangrado. El examen patológico mostró que el 70% de las lesiones eran tumores neuroendocrinos (G1). En el seguimiento se observó un caso de recurrencia, el cual se trató con éxito mediante una disección endoscópica de la submucosa. No hubo recurrencia de tumores en un período de seguimiento medio de 41 meses en los 39 pacientes restantes.

Conclusiones

La mayoría de los TES rectales pequeños que surgen de la muscularis mucosae o submucosa son tumores neuroendocrinos y requieren de un tratamiento adecuado. La resección endoscópica asistida por capuchón es simple, eficaz y segura para resecar tales lesiones y la USE es útil para la detección de casos.

Palabras clave:
Tumor subepitelial rectal
Resección endoscópica asistida por capuchón
Ultrasonografía endoscópica

Article

These are the options to access the full texts of the publication Gastroenterología y Hepatología (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Gastroenterología y Hepatología (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos