title: Efficacy of endoscopic submucosal resection with a ligation device for removing small rectal carcinoid tumor compared with endoscopic mucosal resection: analysis of 100 cases.
abstract: OBJECTIVE
  Conventional endoscopic mucosal resection (EMR) of carcinoid tumors is often associated with involvement of the resection margin, which necessitates further intervention. Endoscopic submucosal resection with a ligation device (ESMR-L) is a novel technique for the removal of carcinoid tumors. The aim of the present study was to compare the clinical usefulness of endoscopic submucosal resection with a ligation device with that of EMR for the complete resection of rectal carcinoid tumors.
  
  
  METHODS
  Between January 2001 and October 2010, a total of 100 patients with 100 rectal carcinoid tumors that were estimated to be 10 mm or less in diameter and that were resected either using ESMR-L or EMR were recruited for this study. The complete resection rate and complications associated with these two procedures were analyzed.
  
  
  RESULTS
  Forty-five out of 100 lesions were resected using ESMR-L, and 55 lesions were resected using EMR. Histopathologically, all tumors were free from lymphovascular and perineural invasion. The overall ESMR-L complete resection rate was higher than that of EMR (93.3% vs 65.5%, respectively, P = 0.001). Furthermore, the location of the tumors had no influence on the complete resection rate when ESMR-L was carried out, in contrast to the results of EMR. The procedure-related variables of procedure time and complication rate were not significantly different between the two groups.
  
  
  CONCLUSIONS
  ESMR-L is a significantly superior modality to EMR for the complete removal of small rectal carcinoid tumors that are 10 mm or less in diameter.
authors.affiliation: Department of Internal Medicine,Kosin University College of Medicine, 34 Amnam-dong, Seo-gu, Busan, Korea. drhhkim@gmail.com
authors.forename: Hyung Hun
authors.initials: HH
authors.lastname: Kim
authors.forename: Seun Ja
authors.initials: SJ
authors.lastname: Park
authors.forename: Sang Heon
authors.initials: SH
authors.lastname: Lee
authors.forename: Hee Ug
authors.initials: HU
authors.lastname: Park
authors.forename: Chul Soo
authors.initials: CS
authors.lastname: Song
authors.forename: Moo In
authors.initials: MI
authors.lastname: Park
authors.forename: Won
authors.initials: W
authors.lastname: Moon
mesh_terms: D002276:Carcinoid Tumor / Q000473:pathology / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006488:Hemostasis, Surgical; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery*; D008026:Ligation / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D056910:Republic of Korea; D012189:Retrospective Studies; D016896:Treatment Outcome