Efficacy of endoscopic submucosal resection with a ligation device for removing small rectal carcinoid tumor compared with endoscopic mucosal resection: analysis of 100 cases.

Abstract

AIM:

  Conventional endoscopic mucosal resection (EMR) of carcinoid tumors is often associated with involvement of the resection margin, which necessitates further intervention. Endoscopic submucosal resection with a ligation device (ESMR-L) is a novel technique for the removal of carcinoid tumors. The aim of the present study was to compare the clinical usefulness of endoscopic submucosal resection with a ligation device with that of EMR for the complete resection of rectal carcinoid tumors.

METHODS:

  Between January 2001 and October 2010, a total of 100 patients with 100 rectal carcinoid tumors that were estimated to be 10 mm or less in diameter and that were resected either using ESMR-L or EMR were recruited for this study. The complete resection rate and complications associated with these two procedures were analyzed.

RESULTS:

  Forty-five out of 100 lesions were resected using ESMR-L, and 55 lesions were resected using EMR. Histopathologically, all tumors were free from lymphovascular and perineural invasion. The overall ESMR-L complete resection rate was higher than that of EMR (93.3% vs 65.5%, respectively, P = 0.001). Furthermore, the location of the tumors had no influence on the complete resection rate when ESMR-L was carried out, in contrast to the results of EMR. The procedure-related variables of procedure time and complication rate were not significantly different between the two groups.

CONCLUSION:

  ESMR-L is a significantly superior modality to EMR for the complete removal of small rectal carcinoid tumors that are 10 mm or less in diameter.

• Authors: Hyung Hun Kim, Seun Ja Park, Sang Heon Lee, Hee Ug Park, Chul Soo Song, Moo In Park, Won Moon
• Journal: Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society (Dig Endosc) Vol. 24 Issue 3 Pg. 159-63 (May 2012) ISSN: 1443-1661 [Electronic] Australia
• PMID: 22507089 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2011 The Authors. Digestive Endoscopy © 2011 Japan Gastroenterological Endoscopy Society.

Topics

• Carcinoid Tumor (pathology, surgery)
• Endoscopy, Gastrointestinal (methods)
• Female
• Hemostasis, Surgical
• Humans
• Intestinal Mucosa (pathology, surgery)
• Ligation (instrumentation)
• Male
• Middle Aged
• Rectal Neoplasms (pathology, surgery)
• Republic of Korea
• Retrospective Studies
• Treatment Outcome