Jeon SM, Lee JH, Hong SP, Kim TI, Kim WH, Cheon JH. Feasibility of salvage endoscopic mucosal resection by using a cap for remnant rectal carcinoids after primary EMR.
Gastrointest Endosc 2011;
73:1009-14. [PMID:
21316666 DOI:
10.1016/j.gie.2010.12.029]
[Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Accepted: 12/20/2010] [Indexed: 02/06/2023]
Abstract
BACKGROUND
Secondary endoscopic treatment for remnant lesions of rectal carcinoid tumors after primary EMR or polypectomy is technically difficult because of fibrosis of residual tissues. EMR by using a cap (EMR-C), a method to resect the submucosal layer by suction by using a transparent cap, may be feasible as a salvage treatment.
OBJECTIVE
To assess the feasibility of salvage EMR-C.
DESIGN
Retrospective analysis.
SETTING
Tertiary academic health care system.
PATIENTS
Thirty-one patients who were referred for salvage treatment of a failed en bloc excision of rectal carcinoid tumors after primary EMR or polypectomy between January 2007 and December 2009.
INTERVENTIONS
Salvage EMR-C for remnant carcinoid tumors in the rectum.
MAIN OUTCOME MEASUREMENTS
Rate of complete resection, complications, length of procedure, and recurrence rate.
RESULTS
The mean age of the patients was 52.0±11.8 years (range 30-78 years). The mean tumor size was 8.9±3.2 mm (range 5.0-13.0 mm). The mean procedure time was 9.1±3.7 minutes, and clear resection margins were pathologically confirmed in all 31 patients. The most common complication of salvage EMR-C was bleeding (7 patients, 22.6%), which was successfully treated by hemoclipping in all cases. The 1-year follow-up colonoscopy and CT results for all patients were negative for recurrence.
LIMITATIONS
Retrospective design and limited cases at a single center.
CONCLUSIONS
EMR-C is a feasible salvage therapeutic option for failed en bloc excision after primary endoscopic treatment of rectal carcinoid tumors.
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