Resection Of Small Carcinoid Tumors Research Articles

More effective endoscopic resection with a two-channel colonoscope for carcinoid tumors of the rectum.

Complete resection of small carcinoid tumors of the rectum is difficult with conventional polypectomy, because these tumors are most often located in the submucosal layer of the rectal wall. To completely remove these tumors, we used a two-channel videocolonoscope with which both a grasping forceps and a polypectomy snare could be used simultaneously. We evaluated its clinical usefulness in comparison with one-channel colonoscopic polypectomy. At Osaka Medical Center for Cancer and Cardiovascular Diseases, seven carcinoid tumors in seven patients were removed with a one-channel videocolonoscope from 1985 to 1992. In 1993 and 1994, ten tumors in nine patients were removed with a two-channel colonoscope. The rate of complete removal of carcinoid tumors with a two-channel videocolonoscope (9 of 10 tumors, 90 percent) was significantly higher (P < 0.05) than with a one-channel videocolonoscope (2 of 7 tumors, 29 percent). No complications occurred during or after endoscopic resection with a two-channel colonoscope. Endoscopic resection with a two-channel colonoscope is a useful and safe method for resection of small carcinoid tumors of the rectum.

Endoscopic laser ablation of duodenal carcinoids: a new treatment modality.

Four cases of polypoidal carcinoid tumors in the duodenum were treated with Nd:YAG laser ablation after histological confirmation. None of the patients had any distant spread of the tumor. All the four tumors were less than 2 cm in size. In each case, the tumor was fully ablated in a single endoscopic laser sitting. All cases were done under local anesthesia and the patients were hospitalized for 1 day. All patients have been symptom free over a mean follow up period of 13 months (6 to 20 months). There has been no endoscopic evidence of local recurrence. Laser therapy is safe and effective and carries no mortality or morbidity. Endoscopic laser ablation is an effective alternative to surgical resection of small carcinoid tumors.