Endoscopic Resection of Rectal Carcinoid Tumors Using Aspiration Lumpectomy

Abstract

We conclude that aspiration lumpectomy is a useful and safe technique for the treatment of small rectal carcinoid tumors contained within the submucosa.

Endoscopic submucosal dissection of a rectal carcinoid tumor using grasping type scissors forceps

“…Technically, complete resection of carcinoid tumors of the rectum is difficult with conventional endoscopic polypectomy [12] , because 76% of these tumors extend into the submucosa [4][5][6] . However, various modified endoscopic therapies, such as strip biopsy [13] , aspiration resection [14] , band-snare resection [15] and endosonography probe-guided band ligation [16] result in good outcome for submucosal rectal carcinoid tumors less than 1 cm, so the application of ESD for carcinoids may be limited. When the lesions are larger, around 1-2 cm (1.1 cm in our case), or massively invade the submucosal layer, which may result in tumor-positive margin resection [3] , incomplete resection with endoscopic resection sometimes results in the need for additional surgery.…”

Indications of Endoscopic Polypectomy for Rectal Carcinoid Tumors and Clinical Usefulness of Endoscopic Ultrasonography

“…22,23 Other new endoscopic procedures for the treatment of rectal carcinoid tumors, which do not require a two-channel colonoscope, include the hood technique, in which resection is performed as the tumor is aspirated into a hood attached to the endoscope tip. 24 With the hood technique, however, strangulation must be performed in a blind fashion. Because the two-channel methods permit the tumor to be strangled under direct vision, it is generally considered superior to the hood technique.…”

ENETS Consensus Guidelines for the Management of Patients with Digestive Neuroendocrine Neoplasms: Colorectal Neuroendocrine Neoplasms

“…Standard polypectomy is commonly performed, but in certain situations considered inadequate, especially if there is evidence of local invasion [41] . Band-snare resection [42] , aspiration lumpectomy [41,43] or strip biopsy [44,45] may be performed endoscopically where appropriate. Transanal resection using a variety of techniques and equipment offers the ability to resect higher lesions and a full-thickness mucosal-muscular resection.…”