Transanal endoscopic microsurgery in the treatment of rectal neuroendocrine tumors: a retrospective 10-year single-center experience.

[PURPOSE] Transanal endoscopic surgery is a recommended full-thickness resection technique for the treatment of rectal neuroendocrine tumors. We aimed to compare the efficacy, safety and follow-up of patients with rectal neuroendocrine tumors treated with transanal endoscopic microsurgery in the primary setting and as salvage therapy after non-radical endoscopic polypectomy.

[METHODS] A retrospective analysis of a 10-year database of patients treated with transanal endoscopic microsurgery was performed. The procedure-related measures, including duration of the procedure, adverse events, and patient-related measures, including age, gender, tumor size, grading, and length of follow-up, were obtained. We compared the primary TEM group with the salvage group.

[RESULTS] In total, 30 patients with rectal neuroendocrine tumors were included in the study; 13 of them received primary treatment and 17 salvage therapy of the scar. Patients receiving primary treatment were significantly older (60.5 vs. 51.7 years). There were no significant differences in patient gender, tumor size and grading, length of follow-up, hospital stay or procedure time. The R0 resection rate was 92.3% in the primary treatment group. Adverse events were mild or managed with endoscopic treatment. Follow-up was slightly but not significantly longer in the primary treatment group and showed no recurrences in both groups of patients.

[CONCLUSIONS] Transanal endoscopic microsurgery is safe and effective for both primary and salvage treatment of rectal neuroendocrine tumors.