[Endoscopic submucosal dissection for rectal carcinoid tumors].
OBJECTIVE
To assess the clinical value of endoscopic submucosal dissection(ESD)for rectal carcinoid tumors.


METHODS
Endoscopic miniprobe ultrasonography was performed in patients with rectal submucosal tumors under colonoscope. ESD was carried out with the needle knife for lesions diagnosed as rectal carcinoid as following: (1)Fluid was injected into the submucosal layer in the rectum to elevate the lesion from the muscle layer. (2)The surrounding mucosa of the lesion was pre-cut. (3)The connective tissue of the submucosa beneath the lesion was dissected.


RESULTS
Five rectal carcinoids ranged from 0.4 to 1.2 cm and the mean resected size was 1.1 cm. All rectal carcinoid tumors were verified by pathological examination with lateral and basal resection margins free of tumor. The mean ESD procedure time (from fluid injection to complete dissection) was 35 min (ranged from 20 to 45 min). Minor bleeding occurred in all of the tumors, and none of patients had massive hemorrhage requiring blood transfusion or emergency colonoscopy due to hematochezia after ESD. One patient had subserosal emphysema due to deep tearing of the muscle layer, and recovered after several days' conservative treatment. All patients were followed up with colonoscopy 1 month after ESD,which confirmed the healing of artificial ulcers.


CONCLUSIONS
ESD is a novel endoscopic treatment that makes it possible to resect the whole rectal carcinoids. Rectal carcinoid tumors can now be treated by ESD to achieve the same therapeutic effect as operation.
Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Ping-hong
PH
Zhou
Li-qing
LQ
Yao
Mei-dong
MD
Xu
Wei-feng
WF
Chen
Yun-shi
YS
Zhong
Wei-dong
WD
Gao
Guo-jie
GJ
He
Xin-yu
XY
Qin
D002276:Carcinoid Tumor / Q000601:surgery*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D016896:Treatment Outcome