title: Endoscopic submucosal dissection for small submucosal tumors of the rectum compared with endoscopic submucosal resection with a ligation device.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for small rectal submucosal tumors (SMTs).
  
  
  METHODS
  Between August 2008 and March 2016, 39 patients were treated with endoscopic submucosal resection with a ligation device (ESMR-L) (n= 21) or ESD (n= 18) for small rectal SMTs in this study. Twenty-five lesions were confirmed by histological evaluation of endoscopic biopsy prior to the procedure, and 14 lesions were not evaluated by endoscopic biopsy. The results for the ESMR-L group and the ESD group were retrospectively compared, including baseline characteristics and therapeutic outcomes.
  
  
  RESULTS
  The rate ofen blocresection was 100% in both groups. Although the rate of complete endoscopic resection was higher in the ESD group than in the ESMR-L group (100%vs95.2%), there were no significant differences between the two groups (P= 0.462). In one patient in the ESMR-L group with a previously biopsied tumor, histological complete resection with a vertical margin involvement of carcinoid tumor could not be achieved, whereas there was no incomplete resection in the ESD group. The mean length of the procedure was significantly greater in the ESD group than in the ESMR-L group (14.7 ± 6.4 minvs5.4 ± 1.7 min,P< 0.05). The mean period of the hospitalization was also significantly longer in the ESD group than in the ESMR-L group (3.7 ± 0.9 dvs2.8 ± 1.5 d,P< 0.05). Postoperative bleeding was occurred in one patient in the ESMR-L group.
  
  
  CONCLUSIONS
  Both ESMR-L and ESD were effective for treatment of small rectal SMTs. ESMR-L was simpler to perform than ESD and took less time.
authors.affiliation: Hideaki Harada, Satoshi Suehiro, Daisuke Murakami, Ryotaro Nakahara, Takanori Shimizu, Yasushi Katsuyama, Kenji Hayasaka, Department of Gastroenterology, New Tokyo Hospital, Chiba 270-2232, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Harada
authors.affiliation: Hideaki Harada, Satoshi Suehiro, Daisuke Murakami, Ryotaro Nakahara, Takanori Shimizu, Yasushi Katsuyama, Kenji Hayasaka, Department of Gastroenterology, New Tokyo Hospital, Chiba 270-2232, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suehiro
authors.affiliation: Hideaki Harada, Satoshi Suehiro, Daisuke Murakami, Ryotaro Nakahara, Takanori Shimizu, Yasushi Katsuyama, Kenji Hayasaka, Department of Gastroenterology, New Tokyo Hospital, Chiba 270-2232, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Murakami
authors.affiliation: Hideaki Harada, Satoshi Suehiro, Daisuke Murakami, Ryotaro Nakahara, Takanori Shimizu, Yasushi Katsuyama, Kenji Hayasaka, Department of Gastroenterology, New Tokyo Hospital, Chiba 270-2232, Japan.
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Nakahara
authors.affiliation: Hideaki Harada, Satoshi Suehiro, Daisuke Murakami, Ryotaro Nakahara, Takanori Shimizu, Yasushi Katsuyama, Kenji Hayasaka, Department of Gastroenterology, New Tokyo Hospital, Chiba 270-2232, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Hideaki Harada, Satoshi Suehiro, Daisuke Murakami, Ryotaro Nakahara, Takanori Shimizu, Yasushi Katsuyama, Kenji Hayasaka, Department of Gastroenterology, New Tokyo Hospital, Chiba 270-2232, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Katsuyama
authors.affiliation: Hideaki Harada, Satoshi Suehiro, Daisuke Murakami, Ryotaro Nakahara, Takanori Shimizu, Yasushi Katsuyama, Kenji Hayasaka, Department of Gastroenterology, New Tokyo Hospital, Chiba 270-2232, Japan.
authors.forename: Yasunaga
authors.initials: Y
authors.lastname: Miyama
authors.affiliation: Hideaki Harada, Satoshi Suehiro, Daisuke Murakami, Ryotaro Nakahara, Takanori Shimizu, Yasushi Katsuyama, Kenji Hayasaka, Department of Gastroenterology, New Tokyo Hospital, Chiba 270-2232, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hayasaka
authors.affiliation: Hideaki Harada, Satoshi Suehiro, Daisuke Murakami, Ryotaro Nakahara, Takanori Shimizu, Yasushi Katsuyama, Kenji Hayasaka, Department of Gastroenterology, New Tokyo Hospital, Chiba 270-2232, Japan.
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Tounou
keywords: Carcinoid tumor; Endoscopic submucosal dissection; Endoscopic submucosal resection with a ligation device; Leiomyoma; Lipoma; Rectum; Submucosal tumor