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Related Experiment Video

Updated: Jun 21, 2026

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
04:09

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors

Published on: February 13, 2026

Endoscopic submucosal dissection for rectal carcinoid tumors.

Naoyuki Yamaguchi1, Hajime Isomoto, Hitoshi Nishiyama

  • 1Department of Endoscopy, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.

Surgical Endoscopy
|July 9, 2009
PubMed
Summary

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Endoscopic submucosal dissection (ESD) effectively removes rectal carcinoids en bloc, achieving a 90% complete resection rate with minimal risk of metastasis. This minimally invasive endoscopic procedure offers a safe and effective treatment option for these specific gastrointestinal tumors.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Endoscopic Procedures

Background:

  • Endoscopic submucosal dissection (ESD) enables en bloc removal of gastrointestinal neoplasms, surpassing endoscopic mucosa resection (EMR).
  • ESD is the preferred treatment for rectal carcinoids with specific histologic features but has seen limited application.
  • Rectal carcinoids are a type of neuroendocrine tumor found in the rectum.

Purpose of the Study:

  • To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for treating rectal carcinoids.
  • To assess the en bloc resection rate and oncologic outcomes of ESD in rectal carcinoid patients.
  • To determine the feasibility of ESD for small rectal carcinoids meeting specific criteria.

Main Methods:

  • ESD was performed on patients with colorectal tumors (≤10 mm diameter, no muscular invasion, no metastases).

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  • The study specifically included patients with rectal carcinoids without lymph node or distant metastasis.
  • Inclusion criteria ensured suitability for minimally invasive endoscopic resection.

    • Main Results:

    • Twenty rectal carcinoid tumors from 20 patients were treated with ESD.
    • All tumors (mean size 7.6 mm) were removed en bloc, with a 90% complete resection rate.
    • One case of perforation was managed conservatively; no recurrence or metastasis was observed in evaluable cases.

    Conclusions:

    • Precise histopathologic assessment of ESD specimens is crucial for reducing recurrence and metastasis.
    • ESD is a safe and effective treatment for small rectal carcinoids, with a low risk of metastatic disease.
    • ESD offers a viable alternative to traditional surgery for selected rectal carcinoid tumors.