Application effect observation of floss assisted internal traction endoscopic submucosal dissection for rectal neuroendocrine neoplasms

Lang Haibo; Zhang Jie; Wang Xiaoyue

doi:10.3760/j.issn.1673-4777.2024.05.016

Abstract：Objective To evaluate the efficacy and safety of internal floss assisted traction endoscopic submucosal dissection(ESD)for rectal neuroendocrine neoplasms(NEN).Methods The data of 34 patients with rectal NEN who underwent colonoscopy and received treatment at the Department of Gastroenterology,Beijing Anzhen Hospital,Capital Medical University from January 2017 to June 2023 were retrospectively analyzed.According to the method of endoscopic surgery,the patients were divided into the dental floss traction ESD treatment group(10 cases)and the traditional ESD treatment group(24 cases).The operation time,surgical complications,postoperative histopathology,hospitalization time and hospitalization cost were compared between the two groups.Results The lesion was located 3-10 cm away from the anus,with a tumor diameter of 3-12 mm.Both lesions were single lesions,and there was no significant difference in the maximum diameter of tumors and the complete resection rate between the two groups(both P＞0.05).The operation time of the dental floss traction ESD treatment group was shorter than that of the traditional ESD treatment group[23.5(16.8,25.3)min vs 30.0(22.8,36.0)min](P=0.012).There were 2 cases(8.3％)of postoperative complications in the traditional ESD treatment group.There was no involvement of muscularis propria and lymphatic vessels in all patients.No postoperative pathology showed that the tumor was close to the cauterization margin in the dental floss traction ESD treatment group,while the postoperative pathology showed that the tumor was close to the burning margin in 5 cases(20.8％)in the traditional ESD treatment group.The hospitalization time of the dental floss traction ESD treatment group was shorter than that of the traditional ESD treatment group[6(5,7)d vs 8(7,11)d](P=0.002).There was no significant difference in hospitalization cost between the two groups(P=0.326).Conclusion Floss assisted ESD in the treatment of rectal NEN is a convenient surgical method,which is conducive to exposing the surgical field,improving the complete resection rate and reducing complications.