Endoscopic diagnosis and treatment of rectal neuroendocrine tumor: A report of 153 cases

Objective To study the morphology of rectal neuroendocrine tumor and the efficacy and safety of its endoscopic removal. Methods Clinical data about 153 rectal neuroendocrine tumor patients admitted to our department from October 2000 to March 2012 were retrospectively analyzed. The endoscopic manifestations of rectal neuroendocrine tumor were summarized. The patients underwent electric resection, endoscopic mucosal resection (EMR), and endoscopic submucosal dissection (ESD), respectively. The safety and efficiency of these 3 procedures were assessed. Results Endoscopy showed submucous hemispherical projections, rigid or tough in texture, yellow or pale in color, with smooth surface and pitting in the center of tumor accompanying erosion. Of the 153 patients, 130 (85%) underwent endoscopic therapy. Of these 130 patients, 2 (1.5%) developed delayed bleeding and recovered after endoscopic hemostasis and conservative treatment, 27 (20.8%) were found to have residual tumor with its cutting edge undetermined. Of these 27 patients, 17 (63%) underwent an additional operation, 10 (37%) received regular colonoscopy which showed no recurrence. One hundred and three patients with negative cutting margin were followed up through telephone for 3.95 ±2.50 years, during which no recurrence and metastasis were found. Conclusion Endoscopic morphology of rectal neuroendocrine tumor can improve its diagnosis. Endoscopic treatment is a simple, safe and effective modality for small rectal neuroendocrine tumor without involvement of mucosa or submucosa. The patients should be regularly followed up after operation.