title: Comparison of Endoscopic Mucosal Resection With Circumferential Incision and Endoscopic Submucosal Dissection for Rectal Carcinoid Tumor.
abstract: OBJECTIVE
  Endoscopic submucosal dissection (ESD) has been a valuable treatment of choice for rectal carcinoid tumors that are endoscopically treatable because of its satisfactory resection rate and low recurrence rate. For treatment of small rectal carcinoids, endoscopic mucosal resection (EMR) is more often chosen by endoscopists because of its safety and time efficiency. We applied circumferential incision and endoscopic mucosal resection (CI-EMR), which is a modification of EMR, to treat rectal carcinoid tumors and compared their efficacy and safety.
  
  
  METHODS
  Between January 2008 and December 2013, we enrolled 66 patients (30 in the ESD group and 36 in the CI-EMR group) at Shengjing Hospital who were pathologically diagnosed with rectal carcinoid tumors <15 mm in diameter. We retrospectively analyzed en bloc resection rates, pathologic complete resection rates, incidences of complications, follow-up outcomes, and procedure times.
  
  
  RESULTS
  The en bloc resection rate and the histologic complete resection rate were similar, but the procedure time was longer in the ESD group than in the CI-EMR group. In cases that were incompletely resected, neither local recurrence nor distant metastasis was detected during follow-up. Similarly minor bleeding occurred in both groups, and no perforation occurred after either procedure.
  
  
  CONCLUSIONS
  CI-EMR showed comparable en bloc resection and histologically complete resection rates and is technically simpler and minimally invasive compared with ESD. Because of its easier performance and shorter procedure time, CI-EMR may be preferable to ESD for resection of rectal carcinoid tumors <15 mm in diameter without invasion or distant metastases.
authors.affiliation: Endoscopy Center, Shengjing Hospital, China Medical University, Shenyang, Liaoning, China.
authors.forename: Ru
authors.initials: R
authors.lastname: Chen
authors.forename: Xiang
authors.initials: X
authors.lastname: Liu
authors.forename: Siyu
authors.initials: S
authors.lastname: Sun
authors.forename: Sheng
authors.initials: S
authors.lastname: Wang
authors.forename: Nan
authors.initials: N
authors.lastname: Ge
authors.forename: Guoxin
authors.initials: G
authors.lastname: Wang
authors.forename: Jintao
authors.initials: J
authors.lastname: Guo
mesh_terms: D000359:Aftercare; D016063:Blood Loss, Surgical; D002276:Carcinoid Tumor / Q000601:surgery*; D000069916:Endoscopic Mucosal Resection / Q000379:methods*; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome