The Effectiveness of Endoscopic Submucosal Resection With a Ligation Device for Small Rectal Carcinoid Tumors

Im, Yeong-Cheol; Jung, Seok Won; Jeong, Hee Seok; Yang, Song-Soo; Kim, Gyu Yeol; Yi, Young Arm; Park, Jae Ho; Kim, Byung Gyu; Jeong, In Du

doi:10.1097/sle.0b013e3182901176

Cited by 9 publications

(8 citation statements)

References 25 publications

(25 reference statements)

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“…Although the patient received no additional interventions, no local recurrence or distant metastases have occurred so far (24 mo after the resection). The patient had a diagnostic biopsy prior to ESMR-L. Im et al[ 18 ] reported that previously biopsied tumors remained independent significant predictors of histological incomplete resection of rectal carcinoid tumors. Previous endoscopic biopsy is likely to produce fibrosis around the lesion.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic submucosal dissection for small submucosal tumors of the rectum compared with endoscopic submucosal resection with a ligation device

Harada

Suehiro

Murakami

et al. 2017

WJGE

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AIMTo evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for small rectal submucosal tumors (SMTs).METHODSBetween August 2008 and March 2016, 39 patients were treated with endoscopic submucosal resection with a ligation device (ESMR-L) (n = 21) or ESD (n = 18) for small rectal SMTs in this study. Twenty-five lesions were confirmed by histological evaluation of endoscopic biopsy prior to the procedure, and 14 lesions were not evaluated by endoscopic biopsy. The results for the ESMR-L group and the ESD group were retrospectively compared, including baseline characteristics and therapeutic outcomes.RESULTSThe rate of en bloc resection was 100% in both groups. Although the rate of complete endoscopic resection was higher in the ESD group than in the ESMR-L group (100% vs 95.2%), there were no significant differences between the two groups (P = 0.462). In one patient in the ESMR-L group with a previously biopsied tumor, histological complete resection with a vertical margin involvement of carcinoid tumor could not be achieved, whereas there was no incomplete resection in the ESD group. The mean length of the procedure was significantly greater in the ESD group than in the ESMR-L group (14.7 ± 6.4 min vs 5.4 ± 1.7 min, P < 0.05). The mean period of the hospitalization was also significantly longer in the ESD group than in the ESMR-L group (3.7 ± 0.9 d vs 2.8 ± 1.5 d, P < 0.05). Postoperative bleeding was occurred in one patient in the ESMR-L group.CONCLUSIONBoth ESMR-L and ESD were effective for treatment of small rectal SMTs. ESMR-L was simpler to perform than ESD and took less time.

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Section: Discussionmentioning

confidence: 99%

Endoscopic submucosal dissection for small submucosal tumors of the rectum compared with endoscopic submucosal resection with a ligation device

Harada

Suehiro

Murakami

et al. 2017

WJGE

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“…The efficacy of ESMR-L in resecting small rectal carcinoids has been compared to that of standard EMR and ESD. Complete resection with histopathologically negative margins has been reported in 94.3-100% of ESMR-L vs. 75.7-80% of EMR cases [ 44 , 45 ]. ESMR-L has shown equivalent complete resection rates to those of ESD (100% vs. 92%, respectively), while offering the advantages of a shorter procedural duration and shorter (if any) hospital admission [ 46 ].…”

Section: Modified Emr Techniquesmentioning

confidence: 99%

Evaluation and long-term outcomes of the different modalities used in colonic endoscopic mucosal resection

Gaglia

Sarkar

2016

aog

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Endoscopic mucosal resection (EMR) has been used in western countries to remove colonic polyps for at least the last two decades. Significant experience has been accumulated and the efficacy of the method has recently been evaluated in a large meta-analysis. A number of variations to modify the technique, including knife-assisted, cap-assisted, ligation devices, and underwater EMR, have been developed in an attempt to improve outcomes. However, to date there are only limited data comparing these techniques or demonstrating the superiority of any one of them. This article reviews the current evidence on the efficacy of each of these modified techniques.

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“…26 Several studies have reported that the complete resection rate of conventional EMR is 30% to 80% 7 , 27 - 31 and an adverse event rate of 4.1%. 28 …”

Section: Endoscopic Resection Methods For Rectal Neuroendocrine Tumorsmentioning

confidence: 99%

Endoscopic treatment for rectal neuroendocrine tumor: which method is better?

Hong

Baek

2022

Clin Endosc

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Recently, research on rectal neuroendocrine tumors (NETs) has increased during the last few decades. Rectal NETs measuring <10 mm without atypical features and confined to the submucosal layer have only 1% risk of metastasis, and the long-term survival probability of patients without metastasis at the time of diagnosis is approximately 100%. Therefore, the current guidelines suggest endoscopic resection of rectal NETs of <10 mm is regarded as a safe therapeutic option. However, there are currently no clear recommendations for technique selection for endoscopic resection. The choice of treatment modality for rectal NETs should be based on the lesion size, endoscopic characteristics, grade of differentiation, depth of vertical involvement, lymphovascular invasion, and risk of metastasis. Moreover, the complete resection rate, complications, and experience at the center should be considered. Modified endoscopic mucosal resection is the most suitable resection method for rectal NETs of <10 mm, because it is an effective and safe technique that is relatively simple and less time-consuming compared with endoscopic submucosal dissection. Endoscopic submucosal dissection should be considered when the tumor size is >10 mm, suctioning is not possible due to fibrosis in the lesion, or when the snaring for modified endoscopic mucosal resection does not work well.

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The Effectiveness of Endoscopic Submucosal Resection With a Ligation Device for Small Rectal Carcinoid Tumors

Abstract: Compared with EMR, ESMR-L is a safe and effective method for histologic complete resection of small rectal carcinoid tumors, especially in patients with previously biopsied carcinoid tumors.

Cited by 9 publications

References 25 publications

Endoscopic submucosal dissection for small submucosal tumors of the rectum compared with endoscopic submucosal resection with a ligation device

Endoscopic submucosal dissection for small submucosal tumors of the rectum compared with endoscopic submucosal resection with a ligation device

Evaluation and long-term outcomes of the different modalities used in colonic endoscopic mucosal resection

Endoscopic treatment for rectal neuroendocrine tumor: which method is better?

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