title: Treatment outcomes according to endoscopic treatment modalities for rectal carcinoid tumors.
abstract: BACKGROUND
  Despite a growing understanding of the clinical effectiveness of endoscopic treatment for small rectal carcinoid tumors, there is still controversy concerning the best endoscopic treatment for resecting rectal carcinoid tumors easily and effectively.
  
  
  OBJECTIVE
  The objective of the present study was to compare the therapeutic efficacy and safety of endoscopic submucosal resection with a ligation device (ESMR-L) with endoscopic submucosal dissection (ESD) for rectal carcinoid tumors. In addition, a conventional snare-based endoscopic mucosal resection (EMR) was included in the study and compared with both ESMR-L and ESD.
  
  
  METHODS
  A retrospective analysis was performed in 115 patients who underwent endoscopic resection of a rectal carcinoid tumor between January 2005 and June 2011. These patients were classified into three groups according to the type of endoscopic procedure: EMR group (n=33), ESMR-L group (n=40) and ESD group (n=44).
  
  
  RESULTS
  The complete resection rate of the EMR group was significantly lower than those of the ESMR-L and ESD groups (77.4 vs. 100 and 97.7%, P=0.002 and P=0.007). Tumor-free vertical margins were significantly greater in the ESMR-L and ESD groups than in the EMR group (ESMR-L and ESD vs. EMR group, P=0.013 and P=0.041). The curative resection rate of rectal carcinoid tumors in the EMR group was 77.4%, which was significantly lower than that of the ESMR-L (95%, 38/40) and EDS groups (97.7%, 43/44) (77.4% vs. 95%, P=0.036 and 77.4% vs. 97.7%, P=0.007).
  
  
  CONCLUSIONS
  Our results show that ESMR-L and ESD might be superior to conventional EMR for the treatment of small rectal carcinoid tumors.
authors.affiliation: Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
authors.forename: Kwang Min
authors.initials: KM
authors.lastname: Kim
authors.forename: Sung June
authors.initials: SJ
authors.lastname: Eo
authors.forename: Sang Goon
authors.initials: SG
authors.lastname: Shim
authors.forename: Jong Hak
authors.initials: JH
authors.lastname: Choi
authors.forename: Byung-Hoon
authors.initials: BH
authors.lastname: Min
authors.forename: Jun Haeng
authors.initials: JH
authors.lastname: Lee
authors.forename: Dong Kyung
authors.initials: DK
authors.lastname: Chang
authors.forename: Young-Ho
authors.initials: YH
authors.lastname: Kim
authors.forename: Poong-Lyul
authors.initials: PL
authors.lastname: Rhee
authors.forename: Jae J
authors.initials: JJ
authors.lastname: Kim
authors.forename: Jong Chul
authors.initials: JC
authors.lastname: Rhee
authors.forename: Jin Yong
authors.initials: JY
authors.lastname: Kim
mesh_terms: D002276:Carcinoid Tumor / Q000473:pathology / Q000601:surgery*; D004210:Dissection; D019723:Endoscopes; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D008026:Ligation / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D011351:Proctoscopy / Q000379:methods*; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies