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Cap-assisted endoscopic mucosal resection (EMR-C) and endoscopic submucosal dissection (ESD) have both been reported to be effective treatment methods for small rectal neuroendocrine tumor (NET) in limited studies. Which one is better has not been determined. We aimed to compare the efficacy and safety of EMR-C and ESD for the treatment of small rectal NET.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ESD group | Active Comparator | In ESD group, enrolled patients will receive the treatment modality of ESD to remove the rectal NET |
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| EMR-C group | Experimental | In EMR-C group, enrolled patients will receive the treatment modality of EMR-C to remove the rectal NET |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ESD procedure | Procedure | ESD were all performed as the standard procedure that has been widely described and used. A diluted sodium hyaluronate solution was injected submucosally. Mucosal incision and submucosal dissection were performed by using either Hook knife (Olympus Medical, Japan) or a dual-knife (Olympus Medical, Japan) . After the resection was finished, all of the visible vessels on the artificial ulcer bed were thoroughly coagulated with argon plasma coagulation to prevent postoperative bleeding. |
| Measure | Description | Time Frame |
|---|---|---|
| complete resection rate(R0 rate) | Complete resection was defined as negative horizontal and vertical margins of specimen. | within 14 days after procedure |
| Measure | Description | Time Frame |
|---|---|---|
| operating time | the time from endoscope in to endoscope out | intraoperative |
| complications rate | Complications were defined as perforation or hemorrhage during or after operation. |
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Inclusion Criteria:
Exclusion Criteria:
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36455222 | Derived | Gao X, Huang S, Wang Y, Peng Q, Li W, Zou Y, Han Z, Cai J, Luo Y, Ye Y, Li A, Bai Y, Chen Y, Liu S, Li Y. Modified Cap-Assisted Endoscopic Mucosal Resection Versus Endoscopic Submucosal Dissection for the Treatment of Rectal Neuroendocrine Tumors </=10 mm: A Randomized Noninferiority Trial. Am J Gastroenterol. 2022 Dec 1;117(12):1982-1989. doi: 10.14309/ajg.0000000000001914. Epub 2022 Aug 23. |
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| EMR-C procedure | Procedure | A transparent cap (MH-593; Olympus) was attached to the forward-viewing endoscope. After the endoscope was inserted to the rectum, the snare passed through the sheath and was looped along the inner lip of the cap. The tumor was then suctioned into the cap and the snare was pushed off and closed. After confirming the appropriate snare placement, both the tumor and the overlying mucosa were resected by electric cautery (Endocut Q, effect 2, VIO 200D; ERBE, Tübingen, Germany), and then the removed tumor was sent for pathological examination. Endoscopic examination then was repeated without the transparent cap in order to evaluate the wound carefully in case there was any perforation or bleeding and to ensure the absence of the residual tumor tissues. If there was spurting bleeding or active bleeding, hot forceps were usually to stop the bleeding. |
|
| within 14 days after procedure |
| length of stay | calculated from the day of admission to day of discharge | within 14 days after procedure |
| hospitalization cost | represent the hospital's costs of being hospitalized | within 14 days after procedure |
| recurrence rate | a new rectal NET recurred confirmed by endoscopy and EUS | one year after procedure |