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Feasibility of salvage endoscopic mucosal resection by using a cap for remnant rectal carcinoids after primary EMR.

Authors
 김원호 ; 김태일 ; 전승민 ; 천재희 ; 홍성필 
Citation
 Gastrointestinal Endoscopy, Vol.73(5) : 1009~1014, 2011 
Journal Title
 Gastrointestinal Endoscopy 
ISSN
 0016-5107 
Issue Date
2011
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.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/92813
DOI
10.1016/j.gie.2010.12.029
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S0016510710025046
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