Abstract | BACKGROUND AND AIMS: Various methods for complete endoscopic resection of rectal carcinoid tumors have been reported; however, the number of cases investigated in each study has been limited. The aim of the present study was to clarify the clinical usefulness of a novel technique named endoscopic submucosal resection with a ligation device (ESMR-L) in a large number of rectal carcinoid tumors. PATIENTS AND METHODS: Between January 1999 and March 2005, a total of 61 patients with 63 rectal carcinoid tumors estimated at 10 mm or less in diameter, without atypical features and resected by ESMR-L were recruited for this analysis. The complete resection rate, complications associated with the procedure, local recurrence, and distant metastases were evaluated. RESULTS: Sixty-one patients were 36 males and 25 females with a mean age of 59 +/- 11 years (24-76 years). Tumor size ranged from 2 to 12 mm in diameter, with an average size of 6.4 +/- 2.4 mm. Fifty-nine lesions (93.6%) were located in the lower rectum (Rb), three in the upper rectum (Ra) and one in the recto-sigmoid colon (Rs). In total, 60 out of 63 lesions (95.2%) were histologically determined to be completely resected. The complete resection rate for lesions located in the Rb was 98.3%, which was significantly higher than that for lesions in Ra and Rs (50%). Minor bleeding associated with the procedure occurred in five lesions (7.9%), but all cases were successfully managed with hemoclips. Histopathologically, all tumors were located in the submucosal layer, and all were classified as classical-type carcinoids without lymphovascular invasion. Neither local recurrence nor distant metastasis was detected during a median follow-up period of 24 months. CONCLUSION: In a large number of cases, ESMR-L proved to be a useful and safe procedure to resect rectal carcinoid tumors 10 mm or less in diameter, especially for those located in the Rb.
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Authors | Yumi Mashimo, Takahisa Matsuda, Toshio Uraoka, Yutaka Saito, Yasushi Sano, Kuangi Fu, Takahiro Kozu, Akiko Ono, Takahiro Fujii, Daizo Saito |
Journal | Journal of gastroenterology and hepatology
(J Gastroenterol Hepatol)
Vol. 23
Issue 2
Pg. 218-21
(Feb 2008)
ISSN: 1440-1746 [Electronic] Australia |
PMID | 18289355
(Publication Type: Evaluation Study, Journal Article)
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Topics |
- Adult
- Aged
- Carcinoid Tumor
(pathology, surgery)
- Endoscopy, Gastrointestinal
(adverse effects, methods, standards)
- Female
- Follow-Up Studies
- Gastrointestinal Hemorrhage
(etiology, therapy)
- Hemostasis, Surgical
- Humans
- Ligation
(instrumentation)
- Male
- Middle Aged
- Rectal Neoplasms
(pathology, surgery)
- Treatment Outcome
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