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Endoscopy 2004; 36(3): 202-205
DOI: 10.1055/s-2004-814248
Original Article
© Georg Thieme Verlag Stuttgart · New York

Saline-Assisted Endoscopic Resection of Rectal Carcinoids: Cap Aspiration Method Versus Simple Snare Resection

T.  Nagai1 , R.  Torishima1 , H.  Nakashima1 , H.  Ookawara1 , A.  Uchida1 , S.  Kai2 , R.  Sato3 , K.  Murakami3 , T.  Fujioka4
  • 1 Department of Gastroenterology, Tsurumi Hospital, Beppu, Japan
  • 2 Department of Pathology, Tsurumi Hospital, Beppu, Japan
  • 3 Second Department of Internal Medicine, Oita Medical University, Oita, Japan
  • 4 Department of General Medicine, Oita Medical University, Oita, Japan
Further Information

Publication History

Submitted 5 February 2003

Accepted after Revision 11 August 2003

Publication Date:
26 February 2004 (online)

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Background and Study Aims: Complete resection of small carcinoid tumors of the rectum is difficult during endoscopic polypectomy, because these tumors are often located in the submucosal layer of the rectal wall. To completely remove these tumors, we have used aspiration lumpectomy. In this study, we evaluated its clinical usefulness in comparison with strip biopsy.
Patients and Methods: We performed strip biopsy (December 1996 through March 2000) or aspiration lumpectomy (April 2000 through February 2003) in a consecutive series of patients with rectal carcinoid tumor. Eight carcinoid tumors in eight patients were resected by strip biopsy, and eight tumors in eight patients were resected by aspiration lumpectomy.
Results: The rate of complete removal of carcinoid tumors with aspiration lumpectomy (100 %) was significantly higher (P < 0.05) than that with strip biopsy (37.5 %).
Conclusions: Endoscopic resection with aspiration lumpectomy is a useful and safe method for resection of small carcinoid tumors of the rectum.

References

  • 1 Ishikawa H, Imanishi K, Okuda S. et al . Effectiveness of endoscopic treatment of carcinoid tumors of the rectum.  Endoscopy. 1989;  21 133-135
    PubMedSearch in Google Scholar
  • 2 Moertel C G. Karnofsky memorial lecture: an odyssey in the land of small tumors.  J Clin Oncol. 1987;  5 1502-1522
    PubMedSearch in Google Scholar
  • 3 Shirouzu K, Isomoto H, Kakegawa T. et al . Treatment of rectal carcinoid tumors.  Am J Surg. 1990;  160 262-265
    PubMedSearch in Google Scholar
  • 4 Burke M, Shepherd N, Mann C. Carcinoid tumors of the rectum and anus.  Br J Surg. 1987;  74 358-361
    CrossrefPubMedSearch in Google Scholar
  • 5 Matsui K, Iwase T, Kitagawa M. Small polypoid-appearing carcinoid tumors of the rectum: clinicopathologic study of 16 cases and effectiveness of endoscopic treatment.  Am J Gastroenterol. 1993;  88 1949-1953
    PubMedSearch in Google Scholar
  • 6 Torii A, Sakai M, Kajiyama T. et al . Endoscopic aspiration mucosectomy as curative endoscopic surgery: analysis of 24 cases of early gastric cancer.  Gastrointest Endosc. 1995;  42 475-479
    CrossrefPubMedSearch in Google Scholar
  • 7 Fujishima H, Misawa T, Maruoka A. et al . Rectal carcinoid tumor: endoscopic ultrasonographic detection and endoscopic removal.  Eur J Radiol. 1993;  16 198-200
    CrossrefPubMedSearch in Google Scholar
  • 8 Imada Y, Sakai M, Kajiyama T. et al . Endoscopic resection of rectal carcinoid tumors using aspiration lumpectomy.  Endoscopy. 1996;  28 34-38
    PubMedSearch in Google Scholar
  • 9 Higaki S, Nishiaki M, Mitani N. et al . Effectiveness of local endoscopic resection for rectal carcinoid tumors.  Endoscopy. 1997;  29 171-175
    Thieme ConnectPubMedSearch in Google Scholar
  • 10 Godwin J D. Carcinoid tumors: an analysis of 2837 cases.  Cancer. 1975;  36 560-569
    CrossrefPubMedSearch in Google Scholar
  • 11 Quan S HQ, Bader G, Berg J W. Carcinoid tumors of the rectum.  Dis Colon Rectum. 1964;  7 197-206
    PubMedSearch in Google Scholar
  • 12 Caldarola V T, Jackman R J, Moertel C G. Carcinoid tumors of the rectum.  Am J Surg. 1964;  107 844-849
    CrossrefPubMedSearch in Google Scholar
  • 13 Soga J. Carcinoids of the rectum: an evaluation of 1,271 reported cases.  Jpn J Surg. 1997;  27 112-119
    CrossrefPubMedSearch in Google Scholar
  • 14 Kvols L K. Gastrointestinal carcinoid tumors and the malignant carcinoid syndrome. In: Feldman M, Scharschmit B, Sleisenger M (eds) Sleisenger and Fordran’s gastrointestinal and liver disease. 6th edn. Philadelphia; WB Saunders 1998: 1831-1843
    Search in Google Scholar
  • 15 Kronborg O. Colon polyps and cancer.  Endoscopy. 2002;  34 69-72
    Thieme ConnectPubMedSearch in Google Scholar
  • 16 Iishi H, Tatsuta M, Iseki K. et al . Endoscopic piecemeal resection with mucosal saline injection of large sessile colorectal polyps.  Gastrointest Endosc. 2000;  51 697-700
    CrossrefPubMedSearch in Google Scholar
  • 17 Suzuki H, Ikeda K. Endoscopic mucosal resection and full thickness resection with complete defect closure for early gastrointestinal malignancies.  Endoscopy. 2001;  33 437-439
    Thieme ConnectPubMedSearch in Google Scholar
  • 18 Mukai M, Iwase H, Himeno R. et al . A novel approach to endoscopic colorectal mucosal resection using a three-channel outer tube and multiple forceps: an experimental assessment.  Endoscopy. 2001;  32 253-256
    Thieme ConnectPubMedSearch in Google Scholar
  • 19 Kajiyama T, Hajiro K, Sakai M. et al . Endoscopic resection of gastrointestinal submucosal lesions: a comparison between strip biopsy and aspiration lumpectomy.  Gastrointest Endosc. 1996;  44 404-410
    CrossrefPubMedSearch in Google Scholar
  • 20 Berkelhammer C, Jasper I, Kirvaitis E. et al . Band-snare resection of small rectal carcinoid tumors.  Gastrointest Endosc. 1999;  50 582-585
    CrossrefPubMedSearch in Google Scholar
  • 21 Ono A, Fujii T, Saito Y. et al . Endoscopic submucosal resection of rectal carcinoid tumors with a ligating device.  Gastrointest Endosc. 2003;  57 583-587
    CrossrefPubMedSearch in Google Scholar
  • 22 Oshitani N, Hamasaki N, Sawa Y. et al . Endoscopic resection of small rectal carcinoid tumors using an aspiration method with a transparent overcap.  J Int Med Res. 2000;  28 241-246
    CrossrefPubMedSearch in Google Scholar
  • 23 Iishi H, Tatsuta M, Yano H. et al . More effective endoscopic resection with a two-channel colonoscope for carcinoid tumors of the rectum.  Dis Colon Rectum. 1996;  39 1438-1439
    CrossrefPubMedSearch in Google Scholar

T. Nagai,M. D. 

Department of Gastroenterology · Tsurumi Hospital

Tsurumi 4333 · Beppu 874-8585 · Japan

Fax: + 81-977-23-7039

Email: nagai3503@k3.dion.ne.jp