title: Usefulness of endoscopic submucosal dissection for the treatment of rectal carcinoid tumors.
abstract: OBJECTIVE
  Various techniques of endoscopy have been developed to treat rectal carcinoids. This retrospective study aimed to evaluate the feasibility and efficacy of endoscopic submucosal dissection for the treatment of rectal carcinoids smaller than 10 mm in diameter.
  
  
  METHODS
  A total of 18 consecutive patients were enrolled with 20 carcinoid tumors that had the following characteristics: the diagnosis of a rectal carcinoid smaller than 10 mm, no endoscopic evidence of muscularis propria invasion, and no evidence of lymph node or distant metastasis (11 men and seven women; median age, 69 years; median tumor size, 4 mm). Tumors were resected by endoscopic submucosal dissection with a needle knife and a hook knife. After marking, a one-third to one-half circumferential mucosal incision was made, and subsequently, the submucosa under the lesion was exfoliated. After the submucosa under the tumor was exfoliated, the residual mucosa was incised and the tumor was removed. Complete resection, complication rates, and operation time were evaluated.
  
  
  RESULTS
  Complete resection was achieved in all cases (100%) without complications. The mean operation time was 34.2 min, which was acceptable in clinical practice.
  
  
  CONCLUSIONS
  Endoscopic submucosal dissection with the strategy described above is feasible and efficacious for selected patients with a rectal carcinoid smaller than 10 mm.
authors.affiliation: Department of Endoscopic Medicine, Mie University Hospital, Mie, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Hamada
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Tanaka
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Tano
authors.forename: Masaki
authors.initials: M
authors.lastname: Katsurahara
authors.forename: Ryo
authors.initials: R
authors.lastname: Kosaka
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Noda
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Aoki
authors.forename: Hideki
authors.initials: H
authors.lastname: Toyoda
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Takei
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Katayama
mesh_terms: D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000379:methods; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome