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Comparative study of two endoscopic resection techniques (anchored snare-tip vs. precut endoscopic mucosal resection) for the treatment of rectal neuroendocrine turmos smaller than 10 mm in size

Not Applicable
Completed
Conditions
Neoplasms
Registration Number
KCT0005148
Lead Sponsor
Asan Medical Center
Brief Summary

Results Seventy-five NETs in 73 patients, including 64 eligible lesions (32 by EMR-P and 32 by Tip-in EMR) were evaluated. The median size of NET by endoscopy was 5.0 mm in the EMR-P group and 6.0 mm in the Tip-in EMR group. In the modified intention-to-treat analysis, R0 resection of the EMR-P group and that of the Tip-in EMR group were 96.9% and 90.6%, respectively (risk difference, -6.3 [95% CI -18.0–5.5]). The resection time in the EMR-P group was longer than that in the Tip-in EMR group (5.0 vs. 2.9 minutes, P<0.001), whereas the post-procedure processing time was similar (2.1 vs. 2.4 minutes, P=0.651). Only one case of complication, immediate postprocedural bleeding, was reported in both arms. The histopathology of the resected specimens in each group will be re-evaluated by the pathologist specialized in neuroendocrine tumors, and the final results can be updated accordingly.

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
All
Target Recruitment
68
Inclusion Criteria

? Patients who will undergo endoscopic treatment for an established or suspected rectal neuroendocrine tumor (NET)
? Patients with an age of 20 to 79 years
? Patients who provided informed consent for this study.

Exclusion Criteria

? An established or suspected rectal NET larger than or equal to 10 mm in endoscopically measured size.
? A incompletely resected rectal NET after a previous therapeutic endoscopic interventio that requires endoscopic submucosal dissection, instead of EMR or modified EMR techniques.
? Without trying precut EMR or ASEMR (interventions for this study), endoscopic submucosal dissection was performed because of the inadequate lifting of the lesion after submucosal injection
? Platelet count less than 80,000/uL or Prolonged PT (over 50%) in the laboratory tests checked within 6 months before the intervention.
? Medical history of other known coagulopathy
? Patients who do not provide informed consent for this study
? Patients who do not show on the scheduled date for intervention and do not undergo the assigned intervention.

Study & Design

Study Type
Interventional Study
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Histologic complete resection rate (per protocol analysis: only include rectal NETs in the final histologic report)
Secondary Outcome Measures
NameTimeMethod
Procedure completion rate (intention-to-treat for all lesions / per protocol analysis for the lesions with NETs in the final diagnosis);Resection time (intention-to-treat for all lesions / per protocol analysis for the lesions with NETs in the final diagnosis);Procedure time including endoscopic hemostasis time (intention-to-treat for all lesions / per protocol analysis for the lesions with NETs in the final diagnosis);Adverse event rate (intention-to-treat for all lesions / per protocol analysis for the lesions with NETs in the final diagnosis)
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