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Hindi Research Article
Efficacy of Endoscopic Mucosal Resection after Circumferential Mucosal Incision of Small Rectal Carcinoid Tumors
| Yosuke Mochizuki1*, Yasuharu Saito1, Osamu Inatomi2, Shigeki Bamba2, Yoshihide Fujiyama2, Mitsuaki Ishida3, Tomoyuki Tsujikawa4 and Akira Andoh5 | |
| 1Division of Digestive Endoscopy, Shiga University of Medical Science, Japan | |
| 2Department of Internal Medicine, Shiga University of Medical Science, Japan | |
| 3Department of Clinical Laboratory Medicine, Shiga University of Medical Science, Japan | |
| 4Division of Comprehensive Internal Medicine, Shiga University of Medical Science, Japan | |
| 5Division of Mucosal Immunology, Graduate School of Medicine, Shiga University of Medical Science, Japan | |
| Corresponding Author : | Yosuke Mochizuki Division of Digestive Endoscopy Shiga University of Medical Science Seta-Tukinowa, Otsu 520-2192, Japan Tel: 81-77-548-2217 Fax: 81-77-548-2219 E-mail: yousuke@belle.shiga-med.ac.jp |
| Received March 28, 2013; Accepted April 05, 2013; Published April 07, 2013 | |
| Citation: Mochizuki Y, Saito Y, Inatomi O, Bamba S, Fujiyama Y, et al. (2013) Efficacy of Endoscopic Mucosal Resection after Circumferential Mucosal Incision of Small Rectal Carcinoid Tumors. J Gastroint Dig Syst S6:006. doi:10.4172/2161-069X.S6-006 | |
| Copyright: © 2013 Mochizuki Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | |
Abstract
Background: Endoscopic mucosal resection is widely used for treating rectal carcinoid tumors. However, histopathology has revealed that submucosal invasion leads to incomplete resection. Endoscopic submucosal dissection, which enables en bloc resection regardless of tumor size, has recently been reported to be useful in treating rectal carcinoid tumors; however, it is not widely used as standard treatment because of technical demands. We use endoscopic mucosal resection after circumferential mucosal incision, which is performed after mucosal resection around the lesion to treat rectal carcinoid tumors. To our knowledge, this is the first report of endoscopic mucosal resection after circumferential mucosal incision for colorectal carcinoid tumors. Objective: To evaluate the efficacy of this method. Design: Single-center retrospective clinical trial. Setting: Shiga University of Medical Science. Patients: We retrospectively studied 6 patients with rectal carcinoid tumors ≤ 10 mm treated by endoscopic mucosal resection after circumferential mucosal incision, between August 2010 and December 2012 at Shiga University of Medical Science. Interventions: Endoscopic mucosal resection after circumferential mucosal incision. Main outcome measures: En bloc resection rate, procedure time, complications. Results: The mean tumor size was 6.8 ± 1.8 mm (range 4-9 mm). The mean procedure time was 19.7 ± 5.1 min (range, 12-26 min). The en bloc and complete resection rates were 100% (6/6) and 50% (3/6), respectively. All tumor depths were contained in the submucosa, and clear resection margins were pathologically confirmed in all 6 patients. Three patients with lymphovascular involvement required additional radical surgical therapy. There were no complications or distant/local recurrence during the follow-up period (median, 4 months; range 4-26 months). Limitations: This study was limited by its retrospective nature. Conclusions: Endoscopic mucosal resection after circumferential mucosal incision was effective for treating ≤ 10-mm-diameter rectal carcinoid tumors.
