title: Endoscopic submucosal resection with double ligation technique for treatment of small rectal carcinoid tumors.
abstract: OBJECTIVE
  It is difficult to achieve complete endoscopic resection of rectal carcinoid tumors without any procedure-related complications. In this study, we evaluated the efficacy and safety of endoscopic submucosal resection with double ligation (ESMR-DL) for the treatment of small rectal carcinoid tumors.
  
  
  METHODS
  Eleven rectal carcinoid tumors (in 11 patients) were resected by ESMR-DL between November 2001 and April 2004, using a conventional single-channel endoscope with an attached band-ligator device. The lesion was aspirated into the ligator device and an elastic band was placed around the base; a detachable snare was then used to ligate the stalk below the elastic band; and snare resection was performed above the elastic band. The resected specimens were examined with respect to size, histological atypia, depth of invasion, and the histological appearance of the resection margins.
  
  
  RESULTS
  All the lesions were excised completely without any complications. There was no tumor invasion beyond the submucosal layer and there was no evidence of atypia in any of the specimens. Tumor diameter varied from 2.0 mm to 10.0 mm (average 6.2 mm). None of the 11 specimens showed histopathological evidence of tumor involvement at the resection margins. There were no immediate or late complications (bleeding or perforation) after ESMR-DL. There was no local recurrence and there were no distant metastases in any patients during the mean follow-up period of 18 months.
  
  
  CONCLUSIONS
  Endoscopic submucosal resection with double ligation is a useful and safe method for the treatment of small rectal carcinoid tumors.
authors.affiliation: Department of Internal Medicine, Hallym University, College of Medicine, Anyang, Republic of Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Moon
authors.forename: J H
authors.initials: JH
authors.lastname: Kim
authors.forename: C H
authors.initials: CH
authors.lastname: Park
authors.forename: J O
authors.initials: JO
authors.lastname: Jung
authors.forename: W G
authors.initials: WG
authors.lastname: Shin
authors.forename: J P
authors.initials: JP
authors.lastname: Kim
authors.forename: K O
authors.initials: KO
authors.lastname: Kim
authors.forename: T
authors.initials: T
authors.lastname: Hahn
authors.forename: K-S
authors.initials: KS
authors.lastname: Yoo
authors.forename: S H
authors.initials: SH
authors.lastname: Park
authors.forename: C K
authors.initials: CK
authors.lastname: Park
mesh_terms: D002276:Carcinoid Tumor / Q000473:pathology / Q000601:surgery*; D004396:Coloring Agents; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D007203:Indigo Carmine; D008026:Ligation; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D004396:Coloring Agents; D007203:Indigo Carmine