Spannungsfeld endoskopische Resektionsverfahren bei GEP-NET // Endoscopic resection for GEP-NET
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Spannungsfeld endoskopische Resektionsverfahren bei GEP-NET // Endoscopic resection for GEP-NET. / Ehlken, Hanno; Younis, Fadi; Wolter, Stefan; Schrader, Jörg.
in: ZBL CHIR, Jahrgang 147, Nr. 3, 06.2022, S. 256-263.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Spannungsfeld endoskopische Resektionsverfahren bei GEP-NET // Endoscopic resection for GEP-NET
AU - Ehlken, Hanno
AU - Younis, Fadi
AU - Wolter, Stefan
AU - Schrader, Jörg
N1 - Thieme. All rights reserved.
PY - 2022/6
Y1 - 2022/6
N2 - Neuroendocrine tumours (NET) are rare tumours of the gastrointestinal tract. Many of these are diagnosed incidentally during routine upper and lower GI endoscopy. Complete surgical resection is the treatment of choice for localised tumours. For small tumours with no associated risk factors for metastases, endoscopic resection can be performed with curative intent. This endoscopic approach is standard of care for gastric, duodenal and rectal NET. In contrast, NET of the jejunum and ileum should not be treated endoscopically, as they exhibit a high rate of metastases independent of tumour size. The feasibility of an endoscopic resection is defined by the technical possibility of achieving an R0 resection, the complication rate of the procedure and the suspected rate of lymph node metastases. In general, endoscopic resection is recommended for tumours less than 1 cm in size, since they can be successfully endoscopically resected without major complications and carry a low risk of metastases. All tumours above 2 cm should be surgically resected, as endoscopic R0 resection is unlikely and risk of lymph node metastases is high. Tumours of between 1 cm and 2 cm could be approached by both surgical or endoscopic resection. A novel approach for these "in between" tumours is a combined endoscopic-laparoscopic rendezvous to achieve limited organ-sparing resection with maximal safety. This approach is particularly useful for duodenal NET as the risk of perforation is high for endoscopic resection.
AB - Neuroendocrine tumours (NET) are rare tumours of the gastrointestinal tract. Many of these are diagnosed incidentally during routine upper and lower GI endoscopy. Complete surgical resection is the treatment of choice for localised tumours. For small tumours with no associated risk factors for metastases, endoscopic resection can be performed with curative intent. This endoscopic approach is standard of care for gastric, duodenal and rectal NET. In contrast, NET of the jejunum and ileum should not be treated endoscopically, as they exhibit a high rate of metastases independent of tumour size. The feasibility of an endoscopic resection is defined by the technical possibility of achieving an R0 resection, the complication rate of the procedure and the suspected rate of lymph node metastases. In general, endoscopic resection is recommended for tumours less than 1 cm in size, since they can be successfully endoscopically resected without major complications and carry a low risk of metastases. All tumours above 2 cm should be surgically resected, as endoscopic R0 resection is unlikely and risk of lymph node metastases is high. Tumours of between 1 cm and 2 cm could be approached by both surgical or endoscopic resection. A novel approach for these "in between" tumours is a combined endoscopic-laparoscopic rendezvous to achieve limited organ-sparing resection with maximal safety. This approach is particularly useful for duodenal NET as the risk of perforation is high for endoscopic resection.
KW - Endoscopy, Gastrointestinal/methods
KW - Humans
KW - Lymphatic Metastasis
KW - Neuroendocrine Tumors/diagnosis
KW - Rectal Neoplasms/surgery
U2 - 10.1055/a-1829-7370
DO - 10.1055/a-1829-7370
M3 - SCORING: Zeitschriftenaufsatz
C2 - 35705087
VL - 147
SP - 256
EP - 263
JO - ZBL CHIR
JF - ZBL CHIR
SN - 0044-409X
IS - 3
ER -