The effectiveness of endoscopic submucosal resection with a ligation device for small rectal carcinoid tumors: focused on previously biopsied tumors.
OBJECTIVE
To evaluate the effectiveness of endoscopic submucosal resection with a ligation device (ESMR-L) on histologic complete resection for the treatment of small rectal carcinoid tumors in comparison with the treatment with endoscopic mucosal resection (EMR) alone.


METHODS
Thirty-five patients with small rectal carcinoid tumors were enrolled prospectively for ESMR-L, and we retrospectively reviewed 74 carcinoid tumor patients who underwent EMR. The comparison between ESMR-L and EMR groups was analyzed including endoscopic and histologic complete resection and complications after resection. We also evaluated the associations of histologic complete resection with clinical and procedure-related factors.


RESULTS
The histologic complete resection rate was significantly higher in ESMR-L than in EMR (94.3% vs. 75.7%, P=0.019). In addition, the resection time was significantly shorter in ESMR-L than in EMR (4.16±1.48 min vs. 5.11±2.47 min, respectively, P=0.014). Moreover, previously biopsied rectal carcinoid tumors were significantly associated with histologic incomplete resection, especially in patients who underwent EMR (odds ratio, 6.28; 95% confidence interval, 1.92-20.58; P=0.002).


CONCLUSIONS
Compared with EMR, ESMR-L is a safe and effective method for histologic complete resection of small rectal carcinoid tumors, especially in patients with previously biopsied carcinoid tumors.
Departments of *General Surgery †Internal Medicine ‡Pathology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea.
Yeong-Cheol
YC
Im
Seok Won
SW
Jung
Hee Jeong
HJ
Cha
Song-Soo
SS
Yang
Gyu Yeol
GY
Kim
Young Arm
YA
Yi
Jae Ho
JH
Park
Byung Gyu
BG
Kim
In Du
ID
Jeong
D001706:Biopsy; D002276:Carcinoid Tumor / Q000175:diagnosis / Q000601:surgery*; D004210:Dissection / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery*; D008026:Ligation / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D011351:Proctoscopy / Q000379:methods*; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome