title: Indications of endoscopic polypectomy for rectal carcinoid tumors and clinical usefulness of endoscopic ultrasonography.
abstract: OBJECTIVE
  This study was designed to define the indications of endoscopic polypectomy for rectal carcinoid tumors and evaluate the diagnostic value of endoscopic ultrasonography.
  
  
  METHODS
  A total of 66 rectal carcinoid tumors treated at our hospital were analyzed histopathologically to clarify risk factors for metastasis. The depth of invasion was determined for 52 lesions examined by endoscopic ultrasonography, and the value of endoscopic ultrasonography for deciding whether a lesion is indicated for endoscopic polypectomy was assessed.
  
  
  RESULTS
  None of the 57 lesions measuring < or = 10 mm in diameter invaded the muscularis propria or had metastasis. Of nine lesions with a diameter of > or = 11 mm, five invaded the muscularis propria and four had metastasis. A central depression was found in three of the lesions with metastasis. The depth of invasion of 49 lesions examined by endoscopic ultrasonography was limited to the submucosa; 3 lesions invaded the muscularis propria. The depth of invasion of all lesions was correctly diagnosed by endoscopic ultrasonography. Ninety-six percent of the lesions that had submucosal invasion with narrowing of the upper two-thirds of the third layer (submucosa) as evaluated by endoscopic ultrasonography could be completely resected by endoscopic polypectomy.
  
  
  CONCLUSIONS
  Rectal carcinoid tumors that satisfy the following three conditions are indicated for local resection, including endoscopic polypectomy: a maximum diameter of < or = 10 mm, no invasion of the muscularis propria, and no depression or ulceration in the lesion. Endoscopic ultrasonography also is useful for estimating the depth of invasion of rectal carcinoid tumors and for determining whether endoscopic polypectomy is indicated.
authors.affiliation: Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Sagamihara-city, 228-8520 Kanagawa-prefecture, Japan.
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Tomoe
authors.initials: T
authors.lastname: Katsumata
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yoshizawa
authors.forename: Miwa
authors.initials: M
authors.lastname: Sada
authors.forename: Masahiro
authors.initials: M
authors.lastname: Igarashi
authors.forename: Katsunori
authors.initials: K
authors.lastname: Saigenji
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Otani
mesh_terms: D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011351:Proctoscopy; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*