Between 1993 and 1997, 11 patients with rectal carcinoids less than 8 mm in diameter (mean size: 5.5 mm) were endoscopically treated at Tsuboi Hospital. Seven patients were treated by polypectomy or endoscopic mucosal resection. Three of the seven lesions were microscopically diagnosed as having positive submucosal margins. The remaining four showed a distance between the tumor and the resection line(DBTRL) of 0 to 0.33 mm. Then, we attempted endoscopic double snare polypectomy (EDSP) in 1996 and 1997. In four consecutive patients, the tumor was completely resected by this method. The DBTRL ranged from 0.08 to 0.75 mm in four lesions resected by EDSP. With endoscopic resection of these tumors, the incidence of positive margins is high using the conventional single snare methods, even when the lesions are less than 10 mm in diameter. EDSP was useful for total removal of small rectal carcinoids.

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