Skip to main content
SpringerLink
Log in

A tailored approach for endoscopic treatment of small rectal neuroendocrine tumor

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Introduction

Resection of rectal neuroendocrine tumors (NETs) less than 1 cm in diameter can be performed using various endoscopic techniques. Endoscopic mucosal resection (EMR) traditionally had suboptimal complete resection rate compared to endoscopic submucosal resection with band ligation (ESMR-L). However, the previous studies did not consider the characteristics of rectal NETs. The aim of our study is to compare the efficacy of ESMR-L and EMR using tailored approach according to the characteristics of rectal NETs.

Methods

82 rectal NETs in 77 patients treated by ESMR-L (n = 48) or EMR (n = 34) between September 2007 and October 2012 were retrospectively analyzed. ESMR-L was used for flat-type tumors or tumors with non-lifting sign after submucosal injection. Conventional EMR was used for elevated-type tumors or tumors with well-lifting sign after submucosal injection.

Results

The pathological complete resection rate was higher in the ESMR-L group (45 lesions, 93.8 %) compared with the EMR group (30 lesions, 88.2 %); however, this difference was not significant (p = 0.441). Overall complication did not differ significantly between the ESMR-L group and the EMR group (p = 0.774). There was one case of a remnant lesion in the ESMR-L group, which was managed by EMR after circumferential pre-cutting (EMR-P), and no recurrence has been detected in either the ESMR-L or EMR group.

Conclusions

ESMR-L and EMR procedures could have a similar excellent complete resection rate, if we select the endoscopic resection technique according to the characteristics of the small rectal NETs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Godwin JD 2nd (1975) Carcinoid tumors. An analysis of 2,837 cases. Cancer 36:560–569

    Article  PubMed  Google Scholar 

  2. Modlin IM, Kidd M, Latich I et al (2005) Current status of gastrointestinal carcinoids. Gastroenterology 128:1717–1751

    Article  PubMed  Google Scholar 

  3. Soga J (1997) Carcinoids of the rectum: an evaluation of 1271 reported cases. Surg Today 27:112–119

    Article  PubMed  CAS  Google Scholar 

  4. Burke M, Shepherd N, Mann CV (1987) Carcinoid tumours of the rectum and anus. Br J Surg 74:358–361

    Article  PubMed  CAS  Google Scholar 

  5. Shim KN, Yang SK, Myung SJ et al (2004) Atypical endoscopic features of rectal carcinoids. Endoscopy 36:313–316

    Article  PubMed  Google Scholar 

  6. Soga J (2005) Early-stage carcinoids of the gastrointestinal tract: an analysis of 1914 reported cases. Cancer 103:1587–1595

    Article  PubMed  Google Scholar 

  7. Gotoda T, Yamamoto H, Soetikno RM (2006) Endoscopic submucosal dissection of early gastric cancer. J Gastroenterol 41:929–942

    Article  PubMed  Google Scholar 

  8. Oka S, Tanaka S, Kaneko I et al (2006) Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer. Gastrointest Endosc 64:877–883

    Article  PubMed  Google Scholar 

  9. Onozato Y, Ishihara H, Iizuka H et al (2006) Endoscopic submucosal dissection for early gastric cancers and large flat adenomas. Endoscopy 38:980–986

    Article  PubMed  CAS  Google Scholar 

  10. Mashimo Y, Matsuda T, Uraoka T et al (2008) Endoscopic submucosal resection with a ligation device is an effective and safe treatment for carcinoid tumors in the lower rectum. J Gastroenterol Hepatol 23:218–221

    Article  PubMed  Google Scholar 

  11. Kim KM, Eo SJ, Shim SG et al (2012) Treatment outcomes according to endoscopic treatment modalities for rectal carcinoid tumors. Clin Res Hepatol Gastroenterol 37:275–282

    Article  PubMed  Google Scholar 

  12. Kim HH, Park SJ, Lee SH et al (2012) Efficacy of endoscopic submucosal resection with a ligation device for removing small rectal carcinoid tumor compared with endoscopic mucosal resection: analysis of 100 cases. Dig Endosc 24:159–163

    Article  PubMed  Google Scholar 

  13. Scherubl H (2009) Rectal carcinoids are on the rise: early detection by screening endoscopy. Endoscopy 41:162–165

    Article  PubMed  CAS  Google Scholar 

  14. Lee SH, Park SJ, Kim HH et al (2012) Endoscopic resection for rectal carcinoid tumors: comparison of polypectomy and endoscopic submucosal resection with band ligation. Clinical Endosc 45:89–94

    Article  Google Scholar 

  15. Ono A, Fujii T, Saito Y et al (2003) Endoscopic submucosal resection of rectal carcinoid tumors with a ligation device. Gastrointest Endosc 57:583–587

    Article  PubMed  Google Scholar 

  16. Cho SB, Park SY, Yoon KW et al (2009) [The effect of post-biopsy scar on the submucosal elevation for endoscopic resection of rectal carcinoids]. Korean J Gastroenterol 53:36–42

    PubMed  Google Scholar 

  17. Park HW, Byeon JS, Park YS et al (2010) Endoscopic submucosal dissection for treatment of rectal carcinoid tumors. Gastrointest Endosc 72:143–149

    Article  PubMed  Google Scholar 

  18. Lee DS, Jeon SW, Park SY et al (2010) The feasibility of endoscopic submucosal dissection for rectal carcinoid tumors: comparison with endoscopic mucosal resection. Endoscopy 42:647–651

    Article  PubMed  CAS  Google Scholar 

  19. Modlin IM, Oberg K, Chung DC et al (2008) Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol 9:61–72

    Article  PubMed  CAS  Google Scholar 

  20. Konishi T, Watanabe T, Kishimoto J et al (2007) Prognosis and risk factors of metastasis in colorectal carcinoids: results of a nationwide registry over 15 years. Gut 56:863–868

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Disclosures

Drs. Jun Heo, Seong Woo Jeon, Min Kyu Jung, Sung Kook Kim, Geun Young Shin, Sang Man Park, Sun Young Ahn, Won Kyung Yoon, Min Kim, and Yong Hwan Kwon have no conflicts of interest or financial ties to disclose.

Author information

Author notes

  1. Seong Woo Jeon

    Present address: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University Hospital, 474 Hakjeongdong, Buk-gu, Daegu, Republic of Korea

Authors and Affiliations

  1. Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea

    Jun Heo, Seong Woo Jeon, Min Kyu Jung, Sung Kook Kim, Geun Young Shin, Sang Man Park, Sun Young Ahn, Won Kyung Yoon, Min Kim & Yong Hwan Kwon

Authors
  1. Jun Heo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seong Woo Jeon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Min Kyu Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sung Kook Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Geun Young Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sang Man Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sun Young Ahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Won Kyung Yoon
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Min Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yong Hwan Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seong Woo Jeon.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Heo, J., Jeon, S.W., Jung, M.K. et al. A tailored approach for endoscopic treatment of small rectal neuroendocrine tumor. Surg Endosc 28, 2931–2938 (2014). https://doi.org/10.1007/s00464-014-3555-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-014-3555-1

Keywords

Search

Navigation