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Objective To investigate the effectiveness and safety of endoscopic mucosal resection with precutting(EMR-P)for the treatment of rectal neuroendocrine neoplasm(RNEN)smaller than 1 cm in diameter.Methods Clinical data of 177 patients with RNEN smaller than 1 cm in diameter from December 2016 to December 2021 were retrospectively analyzed.According to different treatment protocols,177 patients with RNEN were divided into endoscopic mucosal resection(EMR)group(n = 46),EMR-P group(n = 40)and endoscopic submucosal dissection(ESD)group(n = 91).The en bloc resection rate,complete resection rate,operation time,postoperative hospitalization time and incidence of operative complications among the three groups were compared.Results The complete resection rate in the EMR-P group(95.0%)and ESD group(97.8%)were significantly higher than that in the EMR group(87.0%)(P<0.05);The operation time in the EMR-P group(9.86±2.23)min was longer than that in the EMR group(4.12±0.88)min,EMR-P group and EMR group were shorter than that in the ESD group(19.55±3.67)min,the difference was statistically significant(P<0.05);Postoperative hospitalization time in the EMR group was(2.45±0.29)d and EMR-P group was(2.43±0.23)d,which were shorter than that in the ESD group(3.30±0.32)d,and the difference was statistically significant(P<0.05).There were no significant difference in the rates of en bloc resection and operative complications among the three groups(P>0.05).Conclusion EMR-P for the treatment of RNEN<1 cm in diameter has the advantages,such as simple operation,short operation time and hospitalization time,high histological complete resection rate and low complication rate,which is worthy of clinical application.
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Objective:To evaluate the diagnostic value of endoscopic ultrasonography (EUS) in colorectal submucosal lesions, and provide evidence for clinical diagnosis and treatment strategies.Methods:A retrospective analysis was performed on data of 229 patients with colorectal submucosal lesions discovered by electronic colonoscopy and EUS. The diagnosis was confirmed by pathology. The location, type, EUS features of lesions and the coincidence rate of EUS and histopathological diagnosis were analyzed.Results:Colorectal submucosal lesions were common in the rectum (44.98%, 103/229) and ascending colon (15.28%, 35/229). Lipoma was the most common pathological type of colorectal submucosal lesions (34.93%, 80/229), which was commonly located in transverse colon (22.50%, 18/80) and ascending colon (20.00%, 16/80). Neuroendocrine tumor was the second one, accounting for 33.63% (77/229), and was commonly located in rectum (96.10%, 74/77), followed by cyst (18.78%, 43/229). Under EUS, 229 cases of lesions originated from submucosa in 215 cases, muscularis mucosa in 11 cases, and muscularis propria in 3 cases. The overall coincidence rate of EUS and pathological diagnosis was 89.08% (204/229). The coincidence rate of EUS diagnosis was 100.00% (80/80) for lipoma, 5/5 for air-cyst, 3/3 for intestinal stromal tumor, 81.82% (72/88) for neuroendocrine tumor, 89.13% (41/46) for cyst, 1/4 for leiomyoma, 2/5 for lymphangioma, and granulosa cell tumor and neurofibroma were both 0.Conclusion:EUS has a more accurate diagnosis of the origin, echogenicity and pathological properties of colorectal submucosal lesions, but it has certain limitations for the diagnosis of rare tumors such as granulosa cell tumor and neurofibroma.