Objective To compare the efficacy of endoscopic submucosal dissection(ESD)and modified-endoscopic mucosal resection(M-EMR)for G1 rectal neuroendocrine tumors(RNETs).Methods Data of 121 patients with pathologically confirmed G1 RNETs treated with ESD(ni=105)or M-EMR(n=16)in Nanjing Drum Tower Hospital from January 2017 to September 2020 were retrospectively analyzed.The complete resection rate,complication incidence,hospital stay,treatment cost and other indicators of the two groups were compared by using inverse probability of treatment weighting(IPTW).Results There were significant differences in tumor number(x2=8.76,P=0.003),tumor invasion depth(x2=6.96,P=0.008),utilization of metal clips[82.9％(87/105)VS 93.8％(15/16),x2=8.78,P=0.003],number of metal clips(x2=8.41,P=0.016),hemostasis using hot clamp[78.1％(82/105)VS 18.7％(3/16),x2=20.64,P＜0.001],traction procedure[2.9％(3/105)VS 18.7％(3/16),x2=4.45,P=0.035]and treatment cost(17 568.6±8 911.0 yuan VS 8 120.8±1 528.2 yuan,t=3.65,P＜0.001)between the ESD group and the M-EMR group.After verifying the stability of the results using IPTW sensitivity analysis,there was still significant difference in the treatment cost(t=2.07,P＜0.001).Conclusion Both ESD and M-EMR demonstrate comparable efficacy in treating G1 RNETs;however,M-EMR exhibites lower treatment costs.
关键词
直肠肿瘤/神经内分泌瘤/内镜黏膜下剥离术/改良内镜黏膜切除术/逆处理概率加权法
Key words
Rectal neoplasms/Neuroendocrine tumors/Endoscopic submucosal dissection/Modified-endoscopic mucosal resection/Inverse probability of treatment weighting
维普
万方数据