Abstract:
To investigate the safety and clinical efficacy of endoscopic submucosal dissection (ESD) in the treatment of gastrointestinalneuroendocrine neoplasms (GI-NENs).
Methods The clinical and pathological features of 39 patients with GI-NENs who were treatedwith ESD, the efficacy of ESD treatment, complications, and follow-up results were analyzed retrospectively.
Results The 39 cases ofGI-NENs were all neuroendocrine tumors (NETs). According to histopathology and proliferative activity, there were 37 cases of G1, twocases of G2, and no cases of G3, including 23 cases of cancer in the rectum, 12 in the stomach, 4 in the duodenum. Thirty-five lesionsinvaded the mucosa or submucosa, four invaded the muscularis propria, one perforated in the ESD, and two were associated withbleeding. After 6 to 90 months of follow-up, new lesions were found in 1 patient with g-NETs in different parts of the stomach at 5 and34 months after operation, followed by ESD treatment and further follow-up. No lymph node and distant metastases were found, andthe survival rate of the patients was 100%.
Conclusions For GI-NENs without lymph node and distant metastases, the lesion is confined to the submucosa, and a diameter ≤1.0 cm is an absolute indication of ESD. For rectal neuroendocrine neoplasms that have noninvasive muscularis propria with diameters between 1 and 1.5 cm, or for patients with Type 1 gastric neuroendocrine tumors (T1-GNETs) that are predicted to be T2, ESD treatment should be prioritized to preserve gastrointestinal volume and function.