Endoscopy 2006; 38(5): 511-514
DOI: 10.1055/s-2006-925074
Short Communication
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Submucosal Resection with Double Ligation Technique for Treatment of Small Rectal Carcinoid Tumors

J.  H.  Moon1 , J.  H.  Kim1 , C.  H.  Park1 , J.  O.  Jung1 , W.  G.  Shin1 , J.  P.  Kim1 , K.  O.  Kim1 , T.  Hahn1 , K.-S.  Yoo1 , S.  H.  Park1 , C.  K.  Park1
  • 1Department of Internal Medicine, Hallym University, College of Medicine, Anyang, Republic of Korea
Further Information

Publication History

Submitted 23 August 2005

Accepted after revision 21 September 2005

Publication Date:
09 May 2006 (online)

Background and Study Aims: It is difficult to achieve complete endoscopic resection of rectal carcinoid tumors without any procedure-related complications. In this study, we evaluated the efficacy and safety of endoscopic submucosal resection with double ligation (ESMR-DL) for the treatment of small rectal carcinoid tumors.
Patients and Methods: Eleven rectal carcinoid tumors (in 11 patients) were resected by ESMR-DL between November 2001 and April 2004, using a conventional single-channel endoscope with an attached band-ligator device. The lesion was aspirated into the ligator device and an elastic band was placed around the base; a detachable snare was then used to ligate the stalk below the elastic band; and snare resection was performed above the elastic band. The resected specimens were examined with respect to size, histological atypia, depth of invasion, and the histological appearance of the resection margins.

Results: All the lesions were excised completely without any complications. There was no tumor invasion beyond the submucosal layer and there was no evidence of atypia in any of the specimens. Tumor diameter varied from 2.0 mm to 10.0 mm (average 6.2 mm). None of the 11 specimens showed histopathological evidence of tumor involvement at the resection margins. There were no immediate or late complications (bleeding or perforation) after ESMR-DL. There was no local recurrence and there were no distant metastases in any patients during the mean follow-up period of 18 months.
Conclusion: Endoscopic submucosal resection with double ligation is a useful and safe method for the treatment of small rectal carcinoid tumors.

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J. H. Kim, M. D.

Division of Gastroenterology · Department of Internal Medicine · Hallym University · Sacred Heart Hospital

896 Pyungchon-dong · Dongan-gu · Anyang-city · Kyungki-do · 431-796 · Republic of Korea

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Email: bluemoonm@medimail.co.kr