Clinical Endoscopy

Original Articles

Long-term outcome of grade 1 rectal neuroendocrine tumor ≤1 cm after incomplete endoscopic resection: Jong Sun Park, Hye Lynn Jeon, Bumhee Park, Jong Hoon Park, Gil Ho Lee, Sun Gyo Lim, Sung Jae Shin, Kee Myung Lee, Choong-Kyun Noh; Clin Endosc 2025;58(6):871-880. Published online July 22, 2025; DOI: https://doi.org/10.5946/ce.2025.043

Graphical Abstract Abstract PDF PubReader ePub

Background
/Aims: Surveillance strategies for small grade 1 rectal neuroendocrine tumors (G1 rNETs) after incomplete endoscopic resection (ER) remain controversial. We evaluated the long-term outcomes of patients with G1 rNET ≤1 cm after ER who did and did not undergo complete resection.
Methods
We retrospectively evaluated 441 patients with G1 rNETs measuring ≤1 cm after ER between 2011 and 2022. Patients were divided into complete and incomplete resection groups according to histopathological evaluation. Logistic regression analysis identified the risk factors for incomplete resection after ER.
Results
The mean follow-up intervals were 38.6 and 45.7 months in all patients and the incomplete resection group, respectively. No recurrences were observed during the follow-up period. The mean lesion size was 5.5 mm and the complete resection rate was 80.5% (n=355). In the logistic regression analysis, lesion size 5.1 to 10 mm (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.245–4.203; p=0.008), multiple lesions (OR, 8.3; 95% CI, 1.247–54.774; p=0.029), and retroflexion view during the procedure (OR, 4.0; 95% CI, 1.668–9.615; p=0.002) were independent risk factors for incomplete resection.
Conclusions
The prognosis of G1 rNET ≤1 cm after ER was very good, regardless of the histopathological results.

Citations

Citations to this article as recorded by

Prognostic Factors in Neuroendocrine Neoplasms of the Rectum
Frederike Butz, Charlotte Friederike Müller-Debus, Flora Georgina Ecseri, Gianna Sophia Mani, Elif Akgündüz, Agata Dukaczewska, Peter Richard Steinhagen, Uli Fehrenbach, Catarina A. Kunze, Henning Jann, Johann Pratschke, Eva Maria Dobrindt, Martina T. Mog
Cancers.2025; 17(17): 2841. CrossRef

2,265 View
193 Download
1 Web of Science
1 Crossref

A new hemostatic device for gastric endoscopic submucosal dissection: a prospective randomized controlled trial comparing Coajet and Hemograsper in Korea: Sang Un Kim, Seong Woo Jeon; Clin Endosc 2025;58(4):552-560. Published online June 4, 2025; DOI: https://doi.org/10.5946/ce.2024.295

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub: Background
/Aims: Gastric endoscopic submucosal dissection (ESD) is often accompanied by bleeding. Coajet, a new device containing an injection needle, has been found to be useful in achieving hemostasis through monopolar contact. This study aimed to evaluate the efficacy and safety of this new hemostatic device by comparing it to hemostatic forceps (Hemograsper).
Methods
This prospective, randomized, single-center study enrolled consecutive patients scheduled to undergo gastric ESD from February 2022 to January 2023. The Hemograsper group (HG) underwent hemostasis using the conventional method, whereas the Coajet group (CG) used this new tool for lesion marking, submucosal injection in the initial stage of ESD, and then for hemostasis.
Results
A total 56 patients were enrolled in this study (HG, 28; CG, 28). No significant differences in age, sex, diagnosis, location, endoscopic size, or morphology were observed between the two groups. No significant difference in total operative time (HG, 16.0±6.9 minutes vs. CG, 12.4±6.7 minutes; p=0.05) and hemostatic time (HG, 186.6±134.5 seconds vs. CG, 130.4±81.5 seconds; p=0.06) were observed between the two groups. No differences in other procedure-related variables, such as complete en-bloc resection rate, length of admission, grade of immediate bleeding, and delayed bleeding within 30 days (HG, n=1 vs. CG, n=1), were noted.
Conclusions
The new hemostatic device, Coajet, showed comparable efficacy to that of conventional hemostatic forceps for bleeding control and the prevention of delayed bleeding in gastric ESD.

3,434 View
118 Download

Systematic Review and Meta-Analysis

A systematic review on endoscopic ultrasound in gastric neuroendocrine neoplasms: guidelines outpacing evidence: Matteo Marasco, Gianluca Esposito, Marianna Signoretti, Maria Rinzivillo, Francesco Panzuto; Clin Endosc 2025;58(4):525-532. Published online April 24, 2025; DOI: https://doi.org/10.5946/ce.2024.343

Graphical Abstract Abstract PDF PubReader ePub

Background
/Aims: Gastric neuroendocrine neoplasms (g-NENs), though rare, have shown a rise in incidence due to increased endoscopic screening and improved diagnostic awareness. International guidelines recommend the use of endoscopic ultrasound (EUS) in managing g-NENs to evaluate subepithelial lesion size, depth, and lymph node involvement before endoscopic resection. However, the supporting evidence for EUS’s role in g-NENs is scarce and limited.
Methods
According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive literature search was conducted on PubMed to identify studies about the role of EUS in g-NENs, including both retrospective and prospective human studies.
Results
A total of 355 studies were considered; however, only seven studies focusing on EUS’s diagnostic utility in g-NENs were selected, including only 44 patients. EUS showed promise in assessing tumor characteristics critical for endoscopic resection. Nevertheless, its diagnostic accuracy remained variable across lesion types, and its impact on clinical decision-making in g-NENs lacked robust evidence. EUS contributed to subepithelial lesion staging but was underrepresented in neuroendocrine tumor-specific studies, creating a knowledge gap.
Conclusions
This review underscores the need for larger multicenter studies to validate EUS’s efficacy and reliability in g-NEN management. Prospective trials are crucial to strengthen guidelines and provide clearer clinical guidance for managing these tumors.

Citations

Citations to this article as recorded by

Step‐by‐Step Approach to the Incidental Diagnosis of Type I Gastric Neuroendocrine Tumors: Practical Insights
Laura Baldini, Elisabetta Dell'Unto, Maria Rinzivillo, Gianluca Esposito, Francesco Panzuto
JGH Open.2025;[Epub] CrossRef
Differences in Endoscopic Features of Gastric Neuroendocrine Tumor and Neuroendocrine Carcinoma From a Clinicopathological Perspective
Katsunori Matsueda, Noriya Uedo, Masanori Kitamura, Seiji Kawano, Motoyuki Otsuka
JGH Open.2025;[Epub] CrossRef

3,739 View
215 Download
2 Web of Science
2 Crossref

Reviews

Surveillance for metachronous cancers after endoscopic resection of esophageal squamous cell carcinoma: Ryu Ishihara; Clin Endosc 2024;57(5):559-570. Published online May 10, 2024; DOI: https://doi.org/10.5946/ce.2023.263

Search