Clin Endosc.  2012 Mar;45(1):89-94. 10.5946/ce.2012.45.1.89.

Endoscopic Resection for Rectal Carcinoid Tumors: Comparision of Polypectomy and Endoscopic Submucosal Resection with Band Ligation

• Lee SH
• Park SJ
• Kim HH
• Ok KS
• Kim JH
• Jee SR
• Seol SY
• Kim BM

• KMID: 2048838
• DOI: http://doi.org/10.5946/ce.2012.45.1.89

Abstract

BACKGROUND/AIMS
Rectal carcinoid tumors, at diagnosis, are as small as 10 mm or less in about 80% of patients. These tumors are generally removed by endoscopic resection. The aim of this study was to compare treatment efficacy and safety between endoscopic submucosal resection with band ligation (ESMR-L) and conventional polypectomy.
METHODS
Between January 2005 and September 2010, a total of 88 patients, who visited at Busan Paik Hospital and Kosin University Gospel Hospital for endoscopic resection of rectal carcinoid, were reviewed, retrospectively.
RESULTS
Thirty-three cases were treated by ESMR-L, and 55 cases by conventional polypectomy. There were no significant difference in the size of tumor between ESMR-L group and polypectomy group (6.02+/-2.36 vs. 6.49+/-3.24 mm, p=0.474). The rate of positive resection margin was significantly lower in ESMR-L group (2/33, 6.1%) than in polypectomy group (19/55, 34.5%; p=0.002). The rate of positive vertical resection margin, among others, was markedly lower in ESMR-L group (1/33, 3.0%) compared to polypectomy group (19/55, 34.5%; p<0.001).
CONCLUSIONS
ESMR-L, rather than conventional polypectomy, is a useful treatment option for removal of rectal carcinoid tumors less than 10 mm in diameter.

Keyword

Rectal carcinoid tumor; Polypectomy; Band ligation

MeSH Terms

Carcinoid Tumor
Humans
Ligation
Treatment Outcome

Figure

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  Fig. 1 Conventional polypectomy. (A) There is a 6 mm-sized yellow colored submucosal tumor at rectum. (B) Submucosal injection is done. (C) Snaring of the elevated submucosal lesion is done. (D) It shows a post-polypectomy ulcer.

• 

  Fig. 2 Endoscopic submucosal resection with band ligation. (A) There is a 6 mm-sized yellow colored submucosal mass at rectum. (B) Tumor is aspirated by band ligation cap. (C) Tumor is ligated by band. (D) Snaring of the ligated tumor below band is done.

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