Band ligation EMR is safe and effective technique for removal of gastric NENs

Aims Endoscopic resection is the first line approach for removal of small gastric neuroendocrine tumors (NETs). Modified endoscopic mucosal resection (EMR) is a good alternative to conventional EMR and endoscopic submucosal dissection (ESD) [1] [2]. EMR with band ligation (EMR-L) has demonstrated to be safe and effective for removal of rectal NETs [3] [4] [5]. As few data are available on its use in the stomach [6] [7], we wanted to examine its safety and efficacy for the removal of gastric NETs.

Methods We retrospectively analyzed data of 21 gastric NETs resected by EMR-L in 7 patients (4 women and 3 men; age 57+- years) during 8 procedures between 2023 e 2024 in our center. Treatment results, histopathological reports and follow-up data were examined.

Results En bloc resection rate and complete resection rate were both 100%. 7/8 (87.5%) procedures were conducted under sedonalagesia on an outpatient basis; only 1 procedure was performed under narcosis in an hospitalized patient. No intraoperative or delayed bleeding was observed. Perforation occurred in 2/21 lesions (9,5%), both successfully managed during the same endoscopic procedure with through-the-scope clips closure, no subsequent treatments were necessary. Histopathological NET diameter ranged from 3 mm to 12 mm (average diameter: 5.09 mm+- 2.7 mm); 4 were G2 NETs (19%), 17 were G1 NETs. The lateral and vertical margins were negative in all cases. 5 of 7 patients (19/21 NETs) received endoscopic follow-up and no recurrence was observed (mean follow-up period: 11.5±3.8 months).

Conclusions EMR-L seems an effective, safe and relatively simple method for endoscopic resection of small submucosal gastric NETs. Further prospective randomized trials are necessary to confirm our results and to compare EMR-L with other techniques.

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

• References

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Publication History

Article published online:
27 March 2025