Resection of multiple rectal carcinoids with transanal endoscopic microsurgery: Case report

Figure 1 Ultrasound image, surgical specimens and pathological image of the carcinoids. A: Transrectal ultrasound image showing two hypoechoic nodules (arrow), 0.5 cm and 0.72 cm in maximum diameter (lesions 1 and 2, respectively), confined to the submucosal layer of the rectal wall; B: Surgical specimens of the three lesions (two carcinoids, specimen 1 and 2; and one scar site with residual tumor, specimen 3); C: The pathological image revealing neuroendocrine tumor cells within the submucosal layer (hematoxylin and eosin, × 100).

Figure 2 Details of the resection of multiple carcinoids by transanal endoscopic microsurgery. A: Rectoscopic view of the two rectal carcinoids (lesions 1 and 2, see arrows 1 and 2), lesion 3 is not included in this view; B: After removing two carcinoids (lesions 1 and 2, see arrow 2) and one scar site (lesion 3, see arrow 1) with full-thickness excision, defects in the rectal wall (arrows 1 and 2) were closed using running sutures; C: Lesion 1 and 2 defects were adjacent and taken as a whole during the suturing; D: Completion of the suturing of the defect of lesions 1 and 2.