title: Resection of multiple rectal carcinoids with transanal endoscopic microsurgery: case report.
abstract: Multiple rectal carcinoids are rare. Due to the unreliability of endoscopic polypectomy in treating these submucosal lesions, a laparotomy is usually performed. We present a case report on multiple rectal carcinoids with three carcinoid foci<10 mm in diameter located in the mid-rectum. Preoperative examination showed the lesions to be confined to the submucosal layer with no perirectal nodal involvement. A transanal endoscopic microsurgery was successfully performed to remove the three lesions with accurate full-thickness resection followed by secured suture closure. The postoperative pathology revealed neuroendocrine tumors G1 (carcinoids) located within the submucosal layer without lymphatic or vessel infiltration. Both the deep and lateral surgical margins were completely free of tumor cells. The patient recovered quickly and uneventfully. No tumor recurrence was observed at the six-month follow-up. For the multiple small rectal carcinoids without muscularis propria or lymphatic invasion, transanal endoscopic microsurgery offers a reliable and efficient alternative approach to traditional laparotomy for select patients, with the added advantages of minimally invasive surgery.
authors.affiliation: Jiao-Lin Zhou, Guo-Le Lin, Hui-Zhong Qiu, Department of General Surgery, Peking Union Medical College Hospital, Beijing 100730, China.
authors.forename: Jiao-Lin
authors.initials: JL
authors.lastname: Zhou
authors.affiliation: Jiao-Lin Zhou, Guo-Le Lin, Hui-Zhong Qiu, Department of General Surgery, Peking Union Medical College Hospital, Beijing 100730, China.
authors.forename: Guo-Le
authors.initials: GL
authors.lastname: Lin
authors.affiliation: Jiao-Lin Zhou, Guo-Le Lin, Hui-Zhong Qiu, Department of General Surgery, Peking Union Medical College Hospital, Beijing 100730, China.
authors.forename: Da-Chun
authors.initials: DC
authors.lastname: Zhao
authors.affiliation: Jiao-Lin Zhou, Guo-Le Lin, Hui-Zhong Qiu, Department of General Surgery, Peking Union Medical College Hospital, Beijing 100730, China.
authors.forename: Guang-Xi
authors.initials: GX
authors.lastname: Zhong
authors.affiliation: Jiao-Lin Zhou, Guo-Le Lin, Hui-Zhong Qiu, Department of General Surgery, Peking Union Medical College Hospital, Beijing 100730, China.
authors.forename: Hui-Zhong
authors.initials: HZ
authors.lastname: Qiu
mesh_terms: D001706:Biopsy; D002276:Carcinoid Tumor / Q000473:pathology / Q000601:surgery*; D019160:Endosonography; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000601:surgery*; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012812:Sigmoidoscopy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Colorectal; Gastrointestinal surgery; Minimally invasive surgery; Oncological surgery; Technical