Submucosal Dissection in Treating Rectal Neuroendocrine Tumors and Prognostic Analysis

Abstract

Objective: To analyze the application value of modified endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) in rectal neuroendocrine tumors, with a view to providing new clinical options for the early diagnosis and treatment of patients with such tumors, and thus improving their prognosis. Methods: Seventy-two patients with rectal neuroendocrine tumors who underwent surgical treatment in a hospital between October 2023 and September 2024 were selected and divided into a control group and an observation group using the mean score method, each with 36 cases. In the control group, traditional foreign body forceps combined with laparoscopic resection were performed, and in the observation group, modified EMR and ESD were performed as needed. The mass resection rate, histologically intact resection rate, postoperative serum vascular endothelial growth factors (VEGFA, VEGFB, VEGFC levels) in the postoperative period of 7d, and indicators of the rate of related complications of the two groups of patients were compared. Results: The mass resection rate of 91.67% and histological complete resection rate of 94.44% in the observation group were significantly higher than those of 72.22% and 66.67% in the control group; the VEGFA, VEGFB, and VEGFC levels of the observation group were 82.08 ± 7.94 ng/ml, 168.89 ± 16.53 ng/ml, and 121.07 ± 10.75 ng/ml, respectively, in the postoperative period of 7 d after surgery; the levels were significantly higher than those of the control group: 68.39 ± 6.82 ng/ml, 141.06 ± 14.12 ng/ml, and 98.45 ± 9.87 ng/ml, respectively, and the difference was statistically significant (P < 0.05); the patients in the observation group had a lower rate of surgical complications than those in the control group (2.78% vs 8.33%), the difference was not statistically significant (P > 0.05). Conclusion: Modified EMR and ESD in rectal neuroendocrine tumors are effective, not only can it effectively improve the rate of mass resection and histological integrity of the resection rate, but it can also further improve the level of serum vascular endothelial growth factor (VEGFA, VEGFB, VEGFC); thus, it is recommended to be promoted for use in clinical practice.