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. 2025 Jul 2:S0016-5107(25)01782-1.
doi: 10.1016/j.gie.2025.06.045. Online ahead of print.

Endoscopic submucosal resection using a ligation band without injection for rectal neuroendocrine tumors (with video)

Tomoya Ueda  1 , Shunsuke Yoshii  2 , Takashi Kanesaka  1 , Yasuhiro Tani  1 , Yoshiaki Ando  1 , Gentaro Tanabe  1 , Yuta Fujimoto  1 , Noriaki Ito  1 , Nobutoshi Tsukuda  1 , Kazuki Matsuyama  1 , Muneshin Morita  1 , Minoru Kato  1 , Satoki Shichijo  1 , Sachiko Yamamoto  1 , Koji Higashino  1 , Noriya Uedo  1 , Tomoki Michida  1 , Ryu Ishihara  1
Affiliations

Endoscopic submucosal resection using a ligation band without injection for rectal neuroendocrine tumors (with video)

Tomoya Ueda et al. Gastrointest Endosc. .

Abstract

Background and aims: The most appropriate endoscopic resection procedure for small rectal neuroendocrine tumors (NETs) remains unclear. We aimed to evaluate the usefulness of endoscopic submucosal resection using a ligation band (ESMR-L) without submucosal injection compared to ESMR-L with submucosal injection.

Methods: This single-center retrospective study included rectal NETs (≤10 mm) treated with ESMR-L between March 2017 and July 2024. The primary endpoint was sufficient vertical R0 (SVR0) resection, defined as R0 resection with tumor-free vertical margin ≥500 μm.

Results: Of 102 rectal NETs treated with ESMR-L, 71 were resected with injection and 31 without injection. Tumor-free vertical margin distance was significantly greater in ESMR-L without injection (1070 vs 430 μm, P < .001). ESMR-L without injection achieved a significantly higher SVR0 resection rate (67.7% vs 40.8%, P = .018) without an increase in adverse events.

Conclusions: ESMR-L without injection can be simpler and more effective for small rectal NETs than ESMR-L with injection.

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Conflict of interest statement

Disclosure The following authors disclosed financial relationships: T. Kanesaka has received honoraria from Olympus, AstraZeneca, and AI Medical Service. S. Shichijo has received honoraria from FUJIFILM Medical, Boston Scientific, EA Pharma, AstraZeneca, Daiichi-Sankyo, AI Medical Service, Zeria Pharmaceutical, and Janssen Pharmaceutical. S. Yamamoto has received honoraria from MSD. N. Uedo has received honoraria from Olympus, FUJIFILM Medical, Boston Scientific, Daiichi-Sankyo, Takeda Pharmaceutical, EA Pharma, Otsuka Pharmaceutical, AstraZeneca, Miyarisan Pharmaceutical, AI Medical Service, and MC Medical. R. Ishihara has received honoraria from Olympus, FUJIFILM Medical, Daiichi-Sankyo, Miyarisan Pharmaceutical, AI Medical Service, Astra Zeneca, MSD, and Ono Pharmaceutical. All other authors disclosed no financial relationships.

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