A control study of endoscopic mucosal resection and endoscopic submucosal dissection in treating rectal carcinoid tumors

Abstract

Objective To evaluate the efficacy and safety of endoscopic submucosal dissection （ESD） for rectal carcinoid tumors by comparing with endoscopic mucosal resection （EMR）. Methods Da ta of patients with rectal eareinoid tumors between May 2010 to May 2012, who received EMR （n = 24） or ESD （n = 19 ） were reviewed to compare the diameter measured by EUS, operation time, en bloc resection rate, complication, R0 resection rate, and recurrence rate between two methods. Results Diameter measured by EUS in ESD group （ 7.4 ± 5.3 mm ） was significantly higher than that in EMR group （ 5.6 ± 2. lmm, P 〈0. 05）. Mean operation time of ESD group （32. 6 ± 10. 5 min） was significantly longer than that of EMR group （8. 9 ±6. 3 min, P 〈0.05）. En bloc resection and R0 resection rates were similar between EMR （ 100. 0%, 100.0% , respectively） and ESD group （ 100. 0% , 95.0% , respectively）. Complications including perforation and delayed bleeding in EMR group （ 15. 3% ） was significantly higher than those in ESD groups （ 5.0% , P 〈 0. 05 ）. No local recurrence had been detected in either the EMR or ESD group. Conclusion For rectal earcinoid tumor with diameter less than 7mm, EMR can effectively achieve complete resection of the lesions and shorten the operation time. For lesions with diameter greater than 7mm, after muhiple biopsies or partial resection, which results in endoscopic injection flattering intrinsic-negativesigns, ESD might be a better choice. Key words: Rectal; Carcinoid; Endoscopic mucosal resection; Endoscopic submucosal dissection