Endoscopic Resection of Rectal Carcinoids Using Double Snare Polypectomy Technique

Koyama, Nobuatsu; Yoshida, Hatsuo; Nihei, Mitsuhiro; Sakonji, Mitsuaki; Wachi, Eiko

doi:10.1111/j.1443-1661.1998.tb00538.x

Cited by 8 publications

(6 citation statements)

References 11 publications

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“…The heat generated during the resection might have destroyed the neighboring remnant tumor cells,8,31,33,40,41 but we should not exclude the possibility that recurrence or metastasis was not detected in short-term follow-up due to the slow progression of carcinoid tumor 19…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2012

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Background/AimsRectal 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.MethodsBetween 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.ResultsThirty-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).ConclusionsESMR-L, rather than conventional polypectomy, is a useful treatment option for removal of rectal carcinoid tumors less than 10 mm in diameter.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2012

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“…Compared with EMR, ESD is considered a better method for the treatment of rectal carcinoid tumors, but it requires higher technical means and is relatively time consuming and has more complications[ 7 ]. Other improved EMR methods, such as endoscopic double snare polypectomy (EDSP)[ 9 ], EMR with a ligation device (ESMR-L)[ 10 ], EMR with double ligation (ESMR-DL)[ 11 ], or EMR after circumferential pre-cutting (EMR-P)[ 12 ], can remove deeper layers of the tumor without significant complications for small rectal carcinoids. However, the edge remnant is always the problem that needs to be solved for local endoscopic resection.…”

Section: Discussionmentioning

confidence: 99%

Endoloop ligation after endoscopic mucosal resection using a transparent cap: A novel method to treat small rectal carcinoid tumors

Zhang¹,

Luo²,

Xiong³

et al. 2019

WJG

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BACKGROUNDLocal endoscopic resection is an effective method for the treatment of small rectal carcinoid tumors, but remnant tumor at the margin after resection remains to be an issue.AIMTo evaluate the efficacy and safety of resection of small rectal carcinoid tumors by endoloop ligation after cap-endoscopic mucosal resection (LC-EMR) using a transparent cap.METHODSThirty-four patients with rectal carcinoid tumors of less than 10 mm in diameter were treated by LC-EMR (n = 22) or endoscopic submucosal dissection (ESD) (n = 12) between January 2016 and December 2017. Demographic data, complete resection rates, pathologically complete resection rates, operation duration, and postoperative complications were collected. All cases were followed for 6 to 30 mo.RESULTSA total of 22 LC-EMR cases and 12 ESD cases were enrolled. The average age was 48.18 ± 12.31 and 46.17 ± 12.57 years old, and the tumor size was 7.23 ± 1.63 mm and 7.50 ± 1.38 mm, respectively, for the LC-EMR and ESD groups. Resection time in the ESD group was longer than that in the LC-EMR group (15.67 ± 2.15 min vs 5.91 ± 0.87 min; P < 0.001). All lesions were completely resected at one time. No perforation or delayed bleeding was observed in either group. Pathologically complete resection (P-CR) rate was 86.36% (19/22) and 91.67% (11/12) in the LC-EMR and ESD groups (P = 0.646), respectively. Two of the three cases with a positive margin in the LC-EMR group received transanal endoscopic microsurgery (TEM) and tumor cells were not identified in the postoperative specimens. The other case with a positive margin chose follow-up without further operation. One case with remnant tumor after ESD received further local ligation treatment. Neither local recurrence nor lymph node metastasis was found during the follow-up period.CONCLUSIONLC-EMR appears to be an efficient and simple method for the treatment of small rectal carcinoid tumors, which can effectively avoid margin remnant tumors.

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“…7,10 Lifting the mucosal layer from the submucosa by injecting saline within the submucosa has made it feasible to remove sessile tumours by endoscopic snare electroexcision. Koyama et al 4 reported the usefulness of double snare polypectomy for the successful resection of small rectal carcinoid tumours.…”

Section: Endoscopic Resection Of Carcinoid Tumoursmentioning

confidence: 99%

“…The application of endoscopic resection has not been a common treatment because these tumours are sessile and are generated from the deep mucosal layer towards the submucosa; polypectomy or mucosal resection by conventional methods has not proved useful for removing whole tumours. 4 We have found that by lifting the mucosa away from the submucosa with an injection of physiological saline into the submucosa, followed by aspirating the lesion into a short transparent overcap, a sessile tumour can easily be resected using an endoscopic approach.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Resection of Small Rectal Carcinoid Tumours Using an Aspiration Method with a Transparent Overcap

et al. 2000

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Rectal carcinoid tumours are often small and rarely metastatic. Endoscopic resection may, therefore, be the best treatment for small tumours. We diagnosed rectal carcinoid tumours in four women and three men (mean age 53 years; range, 43 -63) between 1994 and 1999. Tumour depth was evaluated using a high-frequency ultrasonographic probe in five of the seven patients. All tumours were resected by endoscopic mucosal resection using an aspiration method with a transparent overcap. Histologically, all tumours were located within the submucosal layer. Tumour cells were found at the resected margin of the lateral side in one patient, and at the bottom of the margin in another. Both patients were followed up with frequent endoscopy, and no local recurrences have been detected at 1-year or 4-year follow-ups. Ultrasonographic examination before resection is useful to estimate tumour depth. Endoscopic resection by an aspiration method with a transparent overcap is safe and effective for the treatment of small rectal carcinoid tumours.

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Endoscopic Resection of Rectal Carcinoids Using Double Snare Polypectomy Technique

Cited by 8 publications

References 11 publications

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

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

Endoloop ligation after endoscopic mucosal resection using a transparent cap: A novel method to treat small rectal carcinoid tumors

Endoscopic Resection of Small Rectal Carcinoid Tumours Using an Aspiration Method with a Transparent Overcap

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