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

Soung Min Jeon, Jin Ha Lee, Sung Pil Hong, Tae Il Kim, Won Ho Kim, JaeHee Cheon

Research output: Contribution to journalArticle

16 Citations (Scopus)

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 3078 years). The mean tumor size was 8.9 ± 3.2 mm (range 5.013.0 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.

Original languageEnglish
Pages (from-to)1009-1014
Number of pages6
JournalGastrointestinal Endoscopy
Volume73
Issue number5
DOIs
Publication statusPublished - 2011 May 1

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Carcinoid Tumor
Rectal Neoplasms
Salvage Therapy
Recurrence
Suction
Colonoscopy
Rectum
Endoscopic Mucosal Resection
Fibrosis
Therapeutics
Hemorrhage
Delivery of Health Care
Neoplasms

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Jeon, Soung Min ; Lee, Jin Ha ; Hong, Sung Pil ; Kim, Tae Il ; Kim, Won Ho ; Cheon, JaeHee. / Feasibility of salvage endoscopic mucosal resection by using a cap for remnant rectal carcinoids after primary EMR. In: Gastrointestinal Endoscopy. 2011 ; Vol. 73, No. 5. pp. 1009-1014.
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Feasibility of salvage endoscopic mucosal resection by using a cap for remnant rectal carcinoids after primary EMR. / Jeon, Soung Min; Lee, Jin Ha; Hong, Sung Pil; Kim, Tae Il; Kim, Won Ho; Cheon, JaeHee.

In: Gastrointestinal Endoscopy, Vol. 73, No. 5, 01.05.2011, p. 1009-1014.

Research output: Contribution to journalArticle

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AU - Jeon, Soung Min

AU - Lee, Jin Ha

AU - Hong, Sung Pil

AU - Kim, Tae Il

AU - Kim, Won Ho

AU - Cheon, JaeHee

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N2 - 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 3078 years). The mean tumor size was 8.9 ± 3.2 mm (range 5.013.0 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.

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