TY - JOUR
T1 - Endoscopic mucosal resection with a ligation device or endoscopic submucosal dissection for rectal carcinoid tumors
T2 - An analysis of 24 consecutive cases
AU - Niimi, Keiko
AU - Goto, Osamu
AU - Fujishiro, Mitsuhiro
AU - Kodashima, Shinya
AU - Ono, Satoshi
AU - Mochizuki, Satoshi
AU - Asada-Hirayama, Itsuko
AU - Konno-Shimizu, Maki
AU - Mikami-Matsuda, Rie
AU - Minatsuki, Chihiro
AU - Yamamichi, Nobutake
AU - Koike, Kazuhiko
PY - 2012/11
Y1 - 2012/11
N2 - Aims: Endoscopic submucosal dissection (ESD) has several advantages over conventional endoscopic mucosal resection, including a higher en bloc resection rate and more accurate pathological estimation. However, ESD is a complex procedure that requires advanced endoscopic skills. The aim of our study is to evaluate the efficacy of endoscopic mucosal resection with a ligation device (EMR-L) compared to ESD for rectal carcinoid tumors. Methods: Between September 2003 and April 2011, 24 rectal carcinoid tumors in 24 patients treated by ESD or EMR-L were retrospectively analyzed. The indications for endoscopic treatment were node-negative rectal carcinoid tumors. We compared the therapeutic outcomes of the ESD group (n = 13) and the EMR-L group (n = 11). Results: Both groups had similar mean tumor sizes (ESD: 5.5 ± 2.1 mm; EMR-L: 4.4 ± 2.2 mm). The rates of en bloc and complete resection were, respectively, 100% and 92.3% for ESD, and 100% and 100% for EMR-L. Perforations did not occur in either group. Postoperative bleeding occurred in one EMR-L case, and it was endoscopically managed. However, there were no differences in therapeutic outcomes between the two groups. The mean procedure time was longer in the ESD group (28.8 ± 16.2 min) than in the EMR-L group (17.4 ± 4.4 min), without a significant difference. The mean hospitalization period was significantly shorter in the EMR-L group (1.8 ± 3.1 day) than in the ESD group (6.2 ± 2.1 day), and eight EMR-L cases were treated in an outpatient setting. Conclusions: EMR-L is a simple and effective procedure that compares favorably to ESD for small rectal carcinoid tumors.
AB - Aims: Endoscopic submucosal dissection (ESD) has several advantages over conventional endoscopic mucosal resection, including a higher en bloc resection rate and more accurate pathological estimation. However, ESD is a complex procedure that requires advanced endoscopic skills. The aim of our study is to evaluate the efficacy of endoscopic mucosal resection with a ligation device (EMR-L) compared to ESD for rectal carcinoid tumors. Methods: Between September 2003 and April 2011, 24 rectal carcinoid tumors in 24 patients treated by ESD or EMR-L were retrospectively analyzed. The indications for endoscopic treatment were node-negative rectal carcinoid tumors. We compared the therapeutic outcomes of the ESD group (n = 13) and the EMR-L group (n = 11). Results: Both groups had similar mean tumor sizes (ESD: 5.5 ± 2.1 mm; EMR-L: 4.4 ± 2.2 mm). The rates of en bloc and complete resection were, respectively, 100% and 92.3% for ESD, and 100% and 100% for EMR-L. Perforations did not occur in either group. Postoperative bleeding occurred in one EMR-L case, and it was endoscopically managed. However, there were no differences in therapeutic outcomes between the two groups. The mean procedure time was longer in the ESD group (28.8 ± 16.2 min) than in the EMR-L group (17.4 ± 4.4 min), without a significant difference. The mean hospitalization period was significantly shorter in the EMR-L group (1.8 ± 3.1 day) than in the ESD group (6.2 ± 2.1 day), and eight EMR-L cases were treated in an outpatient setting. Conclusions: EMR-L is a simple and effective procedure that compares favorably to ESD for small rectal carcinoid tumors.
KW - carcinoid tumor
KW - endoscopic mucosal resection with ligation device
KW - endoscopic submucosal dissection
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UR - http://www.scopus.com/inward/citedby.url?scp=84867840751&partnerID=8YFLogxK
U2 - 10.1111/j.1443-1661.2012.01303.x
DO - 10.1111/j.1443-1661.2012.01303.x
M3 - Article
C2 - 23078437
AN - SCOPUS:84867840751
VL - 24
SP - 443
EP - 447
JO - Digestive Endoscopy
JF - Digestive Endoscopy
SN - 0915-5635
IS - 6
ER -