Endoscopic submucosal resection of rectal carcinoid tumors with a ligation device.
BACKGROUND
Local endoscopic mucosal resection of rectal carcinoid tumors is often associated with margin involvement that requires further intervention. The efficacy of resection of these tumors with endoscopic submucosal resection with a ligation device (ESMR-L) was evaluated.


METHODS
Fourteen rectal carcinoid tumors were treated by ESMR-L between 1999 and 2002. ESMR-L was performed with a conventional colonoscope with an attached band-ligator device. For comparison, 14 rectal carcinoid tumors, treated by either endoscopic mucosal resection or polypectomy between 1990 and 1997, were evaluated as historical controls. All tumors were estimated to be 1 cm or less in diameter.


METHODS
There were no differences between the 2 groups in terms of age, gender, or tumor size. For 6 (43%) patients in the control group, there was tumor involvement at the margin of the resection specimen, whereas all tumors removed by ESMR-L had histopathologically proven negative margins (p < 0.05). The mean vertical resection margin also was significantly deeper in the ESMR-L group (p < 0.05). There was no complication of any procedure.


CONCLUSIONS
ESMR-L is technically simple, minimally invasive, and safe for treatment of small rectal carcinoid tumors contained within the submucosa. ESMR-L provides a deeper resection margin compared with that obtained with conventional endoscopic mucosal resection or polypectomy.
Ono
Akiko
A
Department of Gastroenterology and Endoscopy, National Cancer Center Hospital, Tokyo, Japan.
Fujii
Takahiro
T
Saito
Yutaka
Y
Matsuda
Takahisa
T
Lee
Daniel T y
DT
Gotoda
Takuji
T
Saito
Daizo
D
D000368:Aged; D002276:Carcinoid Tumor / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*