Brief Article
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World J Gastroenterol. Apr 28, 2013; 19(16): 2555-2559
Published online Apr 28, 2013. doi: 10.3748/wjg.v19.i16.2555
Endoscopic mucosal resection for rectal carcinoids under micro-probe ultrasound guidance
Fu-Run Zhou, Liu-Ye Huang, Cheng-Rong Wu
Fu-Run Zhou, Liu-Ye Huang, Cheng-Rong Wu, Department of Gastroenterology, Yu Huang Ding Hospital affiliated to Qingdao University School of Medicine, Yantai 264000, Shandong Province, China
Author contributions: Zhou FR designed the study, performed the endoscopic mucosal resection and wrote the manuscript; Huang LY and Wu CR performed the endoscopic procedures; all authors have read and approved the final version for publication.
Correspondence to: Fu-Run Zhou, Associate Professor, Department of Gastroenterology, Yu Huang Ding Hospital affiliated to Qingdao University School of Medicine, No. 20, Yudong Street, Zhifu District, Yantai 264000, Shandong Province, China. frz_1205@126.com
Telephone: +86-535-6691999 Fax: +86-535-6691999
Received: January 6, 2013
Revised: March 26, 2013
Accepted: March 28, 2013
Published online: April 28, 2013
Processing time: 115 Days and 17.7 Hours
Abstract

AIM: To assess the therapeutic value of endoscopic mucosal resection (EMR) under micro-probe ultrasound guidance for rectal carcinoids less than 1 cm in diameter.

METHODS: Twenty-one patients pathologically diagnosed with rectal carcinoids following colonoscopy in our hospital from January 2007 to November 2012 were included in this study. The patients consisted of 14 men and 7 women, with a mean age of 52.3 ± 12.2 years (range: 36-72 years). The patients with submucosal tumors less than 1 cm in diameter arising from the rectal and muscularis mucosa detected by micro-probe ultrasound were treated with EMR and followed up with conventional endoscopy and micro-probe ultrasound.

RESULTS: All of the 21 tumors were confirmed by micro-probe ultrasound as uniform hypoechoic masses originating from the rectal and muscularis mucosa, without invasion of muscularis propria and vessels, and less than 1 cm in diameter. EMR was successfully completed without bleeding, perforation or other complications. The resected specimens were immunohistochemically confirmed to be carcinoids. Patients were followed up for one to two years, and no tumor recurrence was reported.

CONCLUSION: EMR is a safe and effective treatment for rectal carcinoids less than 1 cm in diameter.

Keywords: Micro-probe ultrasound; Endoscopic mucosal resection; Rectal carcinoid; Endoscopic submucosal dissection; Submucosal tumors

Core tip: Rectal carcinoids are rare neuroendocrine tumors that are often missed or misdiagnosed in clinical settings due to the absence of specific symptoms in the early stage. This study reports on a hospital-based series of 21 patients who were successfully treated and followed up for 1-2 years for small rectal carcinoids less than 1 cm by means of endoscopic mucosal resection (EMR) under micro-probe ultrasound guidance. EMR is found to be a safer option with fewer complications, shorter operation time, and comparable rate of complete removal to endoscopic submucosal dissection, therefore, EMR is more suitable for treating rectal carcinoids less than 1 cm in diameter.