title: Endoscopic submucosal dissection for the treatment of rectal carcinoid tumors 7-16 mm in diameter.
abstract: OBJECTIVE
  Small rectal carcinoid tumors (<10 mm) are often removed via endoscopic submucosal dissection (ESD). However, the use of ESD for tumors of an intermediate size (7-16 mm) is less well documented. This study aimed to evaluate the efficacy and safety of ESD compared with endoscopic mucosal resection using a cap (EMR-C) for the treatment of 7-16-mm rectal carcinoids.
  
  
  METHODS
  From September 2007 to August 2012, 55 patients with large rectal carcinoid tumors were treated by EMR-C (30 cases) or ESD (25 cases). The en bloc resection rate, pathological complete response (pCR) rate, procedure time, and incidence rates of complications, local recurrence, and distant metastasis were evaluated.
  
  
  RESULTS
  The basic and clinical characteristics of the patients in the two groups did not differ significantly (p > 0.05). The mean procedure time was longer for ESD than EMR-C (24.79 ± 4.89 vs. 9.52 ± 2.14 min, p < 0.001). The rates of en bloc resection and pCR were higher with ESD than with EMR-C (100 vs. 83.33 %, and 100 vs. 70.00 %, respectively). No patients in the EMR-C group experienced complications. However, in the ESD group, two cases of perforation occurred, and one patient experienced delayed bleeding. These complications were successfully managed via endoscopical therapy. Five cases of local recurrence were detected after EMR-C, whereas no patients experienced recurrence after ESD.
  
  
  CONCLUSIONS
  Compared with EMR-C, ESD appears to be a more favorable therapeutic option for the treatment of rectal carcinoid tumors less than 16 mm in diameter based on improved rates of pCR and local recurrence.
authors.affiliation: Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Southern Medical University, Nanfang Hospital, Guangzhou, China.
authors.forename: Xianfei
authors.initials: X
authors.lastname: Wang
authors.forename: Li
authors.initials: L
authors.lastname: Xiang
authors.forename: Aimin
authors.initials: A
authors.lastname: Li
authors.forename: Zelong
authors.initials: Z
authors.lastname: Han
authors.forename: Yue
authors.initials: Y
authors.lastname: Li
authors.forename: Yadong
authors.initials: Y
authors.lastname: Wang
authors.forename: Yubin
authors.initials: Y
authors.lastname: Guo
authors.forename: Kangmin
authors.initials: K
authors.lastname: Zuang
authors.forename: Qun
authors.initials: Q
authors.lastname: Yan
authors.forename: Jietao
authors.initials: J
authors.lastname: Zhong
authors.forename: Jing
authors.initials: J
authors.lastname: Xiong
authors.forename: Haiyun
authors.initials: H
authors.lastname: Yang
authors.forename: Side
authors.initials: S
authors.lastname: Liu
mesh_terms: D000328:Adult; D002276:Carcinoid Tumor / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000379:methods*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery*; D007414:Intestinal Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011351:Proctoscopy / Q000379:methods*; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome