title: Selection of cap size in endoscopic submucosal resection with cap aspiration for rectal carcinoid tumors.
abstract: 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.
authors.affiliation: Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Dae Kyung
authors.initials: DK
authors.lastname: Sohn
authors.forename: Kyung Su
authors.initials: KS
authors.lastname: Han
authors.forename: Chang Won
authors.initials: CW
authors.lastname: Hong
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Chang
authors.forename: Seung-Yong
authors.initials: SY
authors.lastname: Jeong
authors.forename: Jae-Gahb
authors.initials: JG
authors.lastname: Park
mesh_terms: 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