title: Comparison of endoscopic resection therapies for rectal carcinoid tumor: endoscopic submucosal dissection versus endoscopic mucosal resection using band ligation.
abstract: BACKGROUND
  Endoscopic mucosal resection (EMR) has been the endoscopic treatment of choice for rectal carcinoid tumors <10 mm in size. Endoscopic submucosal dissection (ESD) may cause more severe complications, longer operation time, and higher cost than EMR.
  
  
  OBJECTIVE
  : To compare EMR using band ligation (EMR-B) method with ESD for the endoscopic treatment of rectal carcinoid tumors.
  
  
  METHODS
  From November 2008 to September 2011, we enrolled consecutive patients with rectal carcinoid tumors <10 mm in diameter and without lymph node enlargement. Rate of complete resection rate, incidence of complications, and length of procedures were evaluated.
  
  
  RESULTS
  Sixty patients were enrolled (31 ESD cases and 29 EMR-B cases). The mean age was 48.03±13.09 years. Both groups had similar mean tumor diameter (EMR-B 4.34±1.75 vs. ESD 5.22±2.09 mm; P=0.084). Resection time was longer in the ESD group than in the EMR-B group (15.09±5.73 vs. 6.37±5.52 min; P<0.001). The complete resection rate was 80.6% (25 of 31) in the ESD group and 82.8% (24 of 29) in the EMR-B group (P=0.833). In incomplete resection cases, neither local recurrence nor distant metastasis was detected during the follow-up period.
  
  
  CONCLUSIONS
  Compared with ESD, EMR-B resulted in a comparable histologically complete resection rate and took less time to perform. Given the advantages of easier and shorter procedure time, EMR-B may be considered the treatment of choice for small rectal carcinoid tumors.
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Cheol W
authors.initials: CW
authors.lastname: Choi
authors.forename: Dae H
authors.initials: DH
authors.lastname: Kang
authors.forename: Hyung W
authors.initials: HW
authors.lastname: Kim
authors.forename: Su B
authors.initials: SB
authors.lastname: Park
authors.forename: Woo S
authors.initials: WS
authors.lastname: Jo
authors.forename: Geun A
authors.initials: GA
authors.lastname: Song
authors.forename: Mong
authors.initials: M
authors.lastname: Cho
mesh_terms: D000328:Adult; D002276:Carcinoid Tumor / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000379:methods*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery*; D008026:Ligation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D011351:Proctoscopy / Q000295:instrumentation / Q000379:methods*; D012004:Rectal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome