Su1406 Comparison of Endoscopic Resection Therapies of Rectal Carcinoid Tumor: ESD Versus EMR Using Band Ligation

Abstract

Su1406 Comparison of Endoscopic Resection Therapies of Rectal Carcinoid Tumor: ESD Versus EMR Using Band Ligation Cheol Woong Choi, Hyung Wook Kim, Dae Hwan Kang, Su Bum Park, Young MI Hong*, Jong Kun HA, MIN Dae Kim, Ji Hoon Yoon Internal medicine, Pusan National University Yangsan Hospital, Yangsan-si, Republic of Korea; Internal Medicine, Bongseng Memorial Hospital, Busan, Republic of Korea Background: Conventional Endoscopic mucosal resection (EMR) has been the endoscopic treatment of choice for rectal carcinoid tumors. Endoscopic submucosal dissection (ESD) is a new method for superficial gastrointestinal neoplasm. However, ESD may cause more severe complication, longer operation time and higher cost. The aim of this study was to compare EMR using band ligation (EMR-B) method with ESD for the endoscopic treatment of rectal carcinoid tumor Methods: From November 2008 to September 2011, we prospectively enrolled consecutive 60 patients with rectal carcinoid tumors less than 10 mm in diameter and with no regional lymph node enlargement shown by CT or EUS. Rate of complete resection rate, incidence of complications, and length of procedures were evaluated. Results: The ESD group contained 31 patients (20 male, 11 female; mean age 48.03 14.44 years), and the EMR-B group contained 29 patients (15 male, 14 female; mean age 47.75 11.73 years). Both groups had similar mean rectal carcinoid tumor diameters (EMR-B 4.34 1.75 mm, ESD 5.22 2.09 mm; p 0.084). Resection time was longer in the ESD group than in the EMR-B group (15.09 5.73 minutes vs 6.37 5.52 minutes, p 0.001). The complete resection rate was 80.6% (25 of 31) in the ESD group and 82.8% (24 of 29 in the EMR-B group (p 0.833). Delayed bleeding occurred in 1 ESD patient (3.2%) was controlled endoscopically. Conclusions: Compared with ESD, EMR-B resulted in a comparable histologically complete resection rate and took shorter time to perform. Given the advantages of easier and shorter procedure time, EMR-B may be considered for treatment choice of small rectal carcinoid tumors.