BACKGROUND: Stage 1 rectal neuroendocrine tumors (NETs) are best treated with endoscopic submucosal dissection (ESD) or transanal endoscopic microsurgery (TEM) for local resection. AIM: To investigate the safety and efficacy of ESD and TEM for local resection of stage 1 rectal NETs. METHODS: This retrospective observational analysis included patients with clinical stage 1 rectal NETs (cT1N0M0, less than 20 mm) who underwent ESD or TEM. The ESD and TEM groups were matched to ensure that they had comparable lesion sizes, lesion locations, and pathological grades. We assessed the differences between groups in terms of RESULTS: Totally, 128 Lesions (ESD = 84
TEM = 44) were included, with 58 Lesions within the matched groups (ESD = 29
TEM = 29). Both the ESD and TEM groups had identical CONCLUSION: Both ESD and TEM were well-tolerated and yielded favorable outcomes for the local removal of clinical stage 1 rectal NETs. ESD exhibits shorter hospital stay and fewer costs than TEM.