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

Abstract

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.

Endoscopic submucosal dissection for treatment of rectal carcinoid tumors

“…Furthermore, the 90% histologically complete resection rate by ESD in the present study is higher than the 38% to 86% rates reported by others using various conventional endoscopic resection methods, including cap-assisted EMR and EMR with a ligation device. [12][13][14]25,26 The higher histologically complete resection rate associated with ESD is clinically significant, given the advantage of complete histological resection of rectal carcinoid tumors. First, the completeness of resection influences the type of subsequent therapy.…”

“…Previous studies showed resection margin tumor involvement in 14% to 62% of EMR cases. [12][13][14] Endoscopic submucosal dissection (ESD) is a powerful new method originally developed for resection of large gastric neoplasms. 15,16 Recently, ESD has been used successfully in the resection of large colorectal neoplasms.…”

Usefulness of transanal endoscopic surgery for carcinoid tumor in the upper and middle rectum

“…Endoscopic mucosal resection is reserved for complete resection of carcinoid tumors because these tumors are sessile and develop from the deep mucosal layer toward the submucosa [9,13]. However, Stinner et al [20] reported that radical resection for rectal carcinoid should be performed only after accurate histologic study of a local resected specimen.…”

Efficacy of Endoscopic Mucosal Resection after Circumferential Mucosal Incision of Small Rectal Carcinoid Tumors

“…EMR with a cap (EMR-C) uses a transparent cap and suction to excise the submucosal layer to ensure a safe vertical margin [35][36][37]. A two-channel endoscope and a holding device with which the submucosal injected portion beneath the tumor is held and lifted are used to perform two-channel EMR [27].…”