Comparison of endoscopic resection therapies for rectal carcinoid tumor: endoscopic submucosal dissection versus endoscopic mucosal resection using band ligation.

BACKGROUND: Endoscopic mucosal resection (EMR) has been the endoscopic treatment of choice for rectal carcinoid tumors <10 mm in size. Endoscopic submucosal dissection (ESD) may cause more severe complications, longer operation time, and higher cost than EMR. AIM: : To compare EMR using band ligation (EMR-B) method with ESD for the endoscopic treatment of rectal carcinoid tumors. METHODS: From November 2008 to September 2011, we enrolled consecutive patients with rectal carcinoid tumors <10 mm in diameter and without lymph node enlargement. Rate of complete resection rate, incidence of complications, and length of procedures were evaluated. RESULTS: Sixty patients were enrolled (31 ESD cases and 29 EMR-B cases). The mean age was 48.03±13.09 years. Both groups had similar mean tumor diameter (EMR-B 4.34±1.75 vs. ESD 5.22±2.09 mm; P=0.084). Resection time was longer in the ESD group than in the EMR-B group (15.09±5.73 vs. 6.37±5.52 min; P<0.001). The complete resection rate was 80.6% (25 of 31) in the ESD group and 82.8% (24 of 29) in the EMR-B group (P=0.833). In incomplete resection cases, neither local recurrence nor distant metastasis was detected during the follow-up period. CONCLUSIONS: Compared with ESD, EMR-B resulted in a comparable histologically complete resection rate and took less time to perform. Given the advantages of easier and shorter procedure time, EMR-B may be considered the treatment of choice for small rectal carcinoid tumors.