Selection of cap size in endoscopic submucosal resection with cap aspiration for rectal carcinoid tumors.
BACKGROUND
Small rectal carcinoid tumors (<or=1 cm in diameter) can be treated by endoscopic resection, but complete resection may be difficult if tumors are located in the deep submucosal layer. This study was performed to identify the clinicopathologic factors affecting the complete resection of small rectal carcinoid tumors, using the endoscopic submucosal resection with cap aspiration technique (ESMR-C).


METHODS
Forty-one consecutive patients with 42 rectal carcinoid tumors who underwent ESMR-C from October 2003 to November 2006 were assessed. Complete resection was defined as a clean margin that was free of tumor invasion at the lateral and inferior edges.


RESULTS
The rate of complete tumor removal by ESMR-C was 85.7% and no complications occurred. The tumor size, location, and method of resection did not significantly affect the completeness of resection. Univariate analysis showed that the rate of complete resection was significantly higher when using 19.2-mm, compared with 13.9-mm, caps (96.0 vs. 70.6%; P = 0.032). Multivariate analysis showed that the cap size was an independent factor predicting the completeness of resection.


CONCLUSIONS
The use of large-sized caps increases the completeness of the resection of rectal carcinoid tumors when using ESMR-C.
Sohn
Dae Kyung
DK
Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Han
Kyung Su
KS
Hong
Chang Won
CW
Chang
Hee Jin
HJ
Jeong
Seung-Yong
SY
Park
Jae-Gahb
JG
D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D013396:Suction / Q000295:instrumentation*; D016896:Treatment Outcome