A pilot randomized control study to evaluate endoscopic resection using a ligation device for rectal carcinoid tumors.
OBJECTIVE
Rectal carcinoid tumors smaller than 10 mm can be resected with local excision using endoscopy. In order to remove rectal carcinoid tumors completely, we evaluated endoscopic mucosal resection with a ligation device in this pilot control randomized study.


METHODS
Fifteen patients were diagnosed with rectal carcinoid tumor (less than 10 mm) in our hospital from 1993 to 2002. There were 9 males and 6 females, with a mean age 61.5 years (range, 34-77 years). The patients had no complaints of carcinoid syndrome symptoms. Fifteen patients were randomly divided into 2 groups: 7 carcinoid tumors were treated by conventional endoscopic resection, and 8 carcinoid tumors were treated by endoscopic resection using a ligation device.


RESULTS
All rectal carcinoid tumors were located at the middle to distal rectum. The size of the tumors varied from 3 mm to 10 mm and background characteristics of the patients were not different in the two groups. The rate of complete removal of carcinoid tumors using a ligation device (100%, 8/8) was significantly higher than that of conventional endoscopic resection (57.1%, 4/7). The three patients had tumor involvement of deep margin, for which additional treatment was performed. No complications occurred during or after endoscopic resection using a ligation device. All patients in the both groups were alive during the 3-year observation period.


CONCLUSIONS
Endoscopic resection using a ligation device is a useful and safe method for resection of small rectal carcinoid tumors.
Sakata
Hiroyuki
H
Department of Internal Medicine, Saga Medical School, 5-1-1 Nabeshima, Saga, Saga 849-8501, Japan. sakatah2@post.saga-med.ac.jp
Iwakiri
Ryuichi
R
Ootani
Akifumi
A
Tsunada
Seiji
S
Ogata
Shinichi
S
Ootani
Hibiki
H
Shimoda
Ryo
R
Yamaguchi
Kanako
K
Sakata
Yasuhisa
Y
Amemori
Sadahiro
S
Mannen
Kotaro
K
Mizuguchi
Masanobu
M
Fujimoto
Kazuma
K
D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000601:surgery*; D005260:Female; D006801:Humans; D008026:Ligation / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011351:Proctoscopy / Q000379:methods*; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D016896:Treatment Outcome