Is a second ligation necessary in endoscopic submucosal resection of rectal carcinoid tumors?

Abstract

With great interest, we have read the article of Moon et al. on endoscopic submucosal resection with a double ligation technique for treatment of rectal carcinoid tumors [1]. They have modified our technique of endoscopic submucosal resection with a ligation device (ESMR-L) [2]; that is, they have applied a second detachable snare to ligate the stalk below the elastic band and performed snare resection above the elastic band. They have employed this modified technique for complete removal of 11 rectal carcinoid tumors, without immediate or late complication such as bleeding or perforation. They concluded that it is a useful and safe method for the treatment of small rectal carcinoid tumors.