Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Feb 16, 2017; 9(2): 70-76
Published online Feb 16, 2017. doi: 10.4253/wjge.v9.i2.70
Endoscopic submucosal dissection for small submucosal tumors of the rectum compared with endoscopic submucosal resection with a ligation device
Hideaki Harada, Satoshi Suehiro, Daisuke Murakami, Ryotaro Nakahara, Takanori Shimizu, Yasushi Katsuyama, Yasunaga Miyama, Kenji Hayasaka, Shigetaka Tounou
Hideaki Harada, Satoshi Suehiro, Daisuke Murakami, Ryotaro Nakahara, Takanori Shimizu, Yasushi Katsuyama, Kenji Hayasaka, Department of Gastroenterology, New Tokyo Hospital, Chiba 270-2232, Japan
Yasunaga Miyama, Department of Health Service Center, Tokyo Medical and Dental University, Tokyo 113-0034, Japan
Shigetaka Tounou, Second Division of Internal Medicine, Teikyo University Chiba Medical Center, Chiba 3426-3, Japan
Author contributions: Harada H wrote the manuscript and analyzed the data; Suehiro S, Murakami D, Nakahara R, Shimizu T, Katsuyama Y, Miyama Y, Hayasaka K and Tounou S collected the data.
Supported by New Tokyo Hospital, Chiba, Japan.
Institutional review board statement: This study was reviewed and approved by the New Tokyo Hospital Institutional Review Committee.
Informed consent statement: The procedure participant provided informed written consent.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hideaki Harada, MD, Director, Department of Gastroenterology, New Tokyo Hospital, 1271 Wanagaya, Matsudo Chiba 270-2232, Japan. nerimaendo@hotmail.co.jp
Telephone: +81-47-7118700 Fax: +81-47-3928718
Received: July 17, 2016
Peer-review started: July 20, 2016
First decision: September 7, 2016
Revised: September 28, 2016
Accepted: November 1, 2016
Article in press: November 2, 2016
Published online: February 16, 2017
Processing time: 211 Days and 23.6 Hours
Abstract
AIM

To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for small rectal submucosal tumors (SMTs).

METHODS

Between August 2008 and March 2016, 39 patients were treated with endoscopic submucosal resection with a ligation device (ESMR-L) (n = 21) or ESD (n = 18) for small rectal SMTs in this study. Twenty-five lesions were confirmed by histological evaluation of endoscopic biopsy prior to the procedure, and 14 lesions were not evaluated by endoscopic biopsy. The results for the ESMR-L group and the ESD group were retrospectively compared, including baseline characteristics and therapeutic outcomes.

RESULTS

The rate of en bloc resection was 100% in both groups. Although the rate of complete endoscopic resection was higher in the ESD group than in the ESMR-L group (100% vs 95.2%), there were no significant differences between the two groups (P = 0.462). In one patient in the ESMR-L group with a previously biopsied tumor, histological complete resection with a vertical margin involvement of carcinoid tumor could not be achieved, whereas there was no incomplete resection in the ESD group. The mean length of the procedure was significantly greater in the ESD group than in the ESMR-L group (14.7 ± 6.4 min vs 5.4 ± 1.7 min, P < 0.05). The mean period of the hospitalization was also significantly longer in the ESD group than in the ESMR-L group (3.7 ± 0.9 d vs 2.8 ± 1.5 d, P < 0.05). Postoperative bleeding was occurred in one patient in the ESMR-L group.

CONCLUSION

Both ESMR-L and ESD were effective for treatment of small rectal SMTs. ESMR-L was simpler to perform than ESD and took less time.

Keywords: Leiomyoma; Lipoma; Rectum; Submucosal tumor; Endoscopic submucosal resection with a ligation device; Endoscopic submucosal dissection; Carcinoid tumor

Core tip: This was a retrospective study to evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) compared with endoscopic submucosal resection with a ligation device (ESMR-L) for small rectal submucosal tumors (SMTs). A total of 39 patients were treated with endoscopic resection for small rectal SMTs; 21 were treated with ESMR-L and 18 were treated with ESD. The results show that both ESMR-L and ESD were effective for treatment of small rectal SMTs. ESMR-L was simpler to perform than ESD and took less time.