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See Latest ArticlesEndoscopic submucosal dissection for rectal carcinoid tumors
Surgical Endoscopy, 07/15/09
Yamaguchi N et al. - In a study to assess the use of endoscopic submucosal dissection (ESD) for rectal carcinoids that have classic histologic architecture with minimal cellular pleomorphism and sparse mitoses, it was concluded that precise histolopathogic assessment of the specimens resected en bloc by ESD may reduce tumor recurrence and metastasis after ESD. As the treatment of choice for small rectal carcinoids, ESD is associated with nominal risks of metastatic disease.
Methods- The ESD procedure was performed for pts with colorectal tumors that fulfilled inclusion criteria specifying tumor with a diameter of 10 mm or less, no muscular layer invasion, and no metastases to the lymph nodes or distal organs.
- The ESD procedure was performed for pts with rectal carcinoids but no node or distal metastasis.
- This study enrolled 20 rectal carcinoid tumors from 20 consecutive pts.
- Mean tumor size was 7.6 mm.
- En bloc removal was achieved for all the tumors, and complete resection (en bloc with tumor-free lateral/basal margins) rate was 90% (18/20).
- 2 cases in which the margins were not evaluable due to burn effects still are free of recurrence and metastasis at this writing.
- Perforation was seen in 1 case, which was managed nonsurgically.
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