Endoscopic submucosal dissection (ESD) for gastrointestinal carcinoid tumors

Area of Science:

• Gastroenterology
• Surgical Endoscopy
• Oncology

Background:

• Gastrointestinal (GI) carcinoid tumors <10 mm, limited to the submucosa, have low metastasis rates.
• Endoscopic submucosal dissection (ESD) is used for these tumors, but data for rectal, gastric, and duodenal carcinoids are limited.
• Safety and efficacy of ESD for gastric and duodenal carcinoid tumors require further elucidation.

Purpose of the Study:

• To evaluate the therapeutic efficacy and safety of endoscopic submucosal dissection (ESD) for gastrointestinal carcinoid tumors.
• To assess complications and follow-up results of ESD in patients with rectal, gastric, and duodenal carcinoid tumors.

Main Methods:

• Retrospective evaluation of 42 gastrointestinal carcinoid tumors (37 rectal, 2 gastric, 3 duodenal) in 41 patients treated with ESD from January 2004 to March 2011.
• Analysis of procedural time, tumor and specimen size, en bloc resection rate, postoperative complications, and recurrence rates.
• Mean follow-up period of 37 months.

Main Results:

• En bloc resection was achieved in 100% of cases (42/42).
• Postoperative bleeding occurred in 5% of rectal cases, managed endoscopically.
• Two duodenal cases experienced perforation, treated conservatively without surgery.

Conclusions:

• Endoscopic submucosal dissection (ESD) is a safe and effective endoscopic treatment for rectal and gastric carcinoid tumors.
• While effective for rectal and gastric sites, alternative treatment modalities may be preferable for duodenal carcinoid tumors.