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Updated: May 23, 2026
The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
Published on: February 13, 2026
Usefulness of endoscopic submucosal dissection for the treatment of rectal carcinoid tumors
Yasuhiko Hamada1, Kyosuke Tanaka, Shunsuke Tano
1Department of Endoscopic Medicine, Mie University Hospital, Mie, Japan.
Background And Aim:
Various techniques of endoscopy have been developed to treat rectal carcinoids. This retrospective study aimed to evaluate the feasibility and efficacy of endoscopic submucosal dissection for the treatment of rectal carcinoids smaller than 10 mm in diameter.
Patients And Methods:
A total of 18 consecutive patients were enrolled with 20 carcinoid tumors that had the following characteristics: the diagnosis of a rectal carcinoid smaller than 10 mm, no endoscopic evidence of muscularis propria invasion, and no evidence of lymph node or distant metastasis (11 men and seven women; median age, 69 years; median tumor size, 4 mm). Tumors were resected by endoscopic submucosal dissection with a needle knife and a hook knife. After marking, a one-third to one-half circumferential mucosal incision was made, and subsequently, the submucosa under the lesion was exfoliated. After the submucosa under the tumor was exfoliated, the residual mucosa was incised and the tumor was removed. Complete resection, complication rates, and operation time were evaluated.
Results:
Complete resection was achieved in all cases (100%) without complications. The mean operation time was 34.2 min, which was acceptable in clinical practice.
Conclusion:
Endoscopic submucosal dissection with the strategy described above is feasible and efficacious for selected patients with a rectal carcinoid smaller than 10 mm.
Insights
Endoscopic submucosal dissection is a feasible and effective treatment for small rectal carcinoids under 10 mm. This minimally invasive endoscopic technique achieved complete tumor resection in all patients without complications.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Endoscopic Surgery
Background:
- Rectal carcinoids are tumors requiring effective treatment.
- Various endoscopic techniques exist for rectal carcinoid treatment.
- Endoscopic submucosal dissection (ESD) is a minimally invasive option.
Purpose of the Study:
- To evaluate the feasibility and efficacy of ESD.
- To assess ESD for rectal carcinoids smaller than 10 mm.
- To determine outcomes in selected patients.
Main Methods:
- Retrospective study of 18 patients with 20 rectal carcinoids (<10 mm).
- Exclusion criteria: muscularis propria invasion, lymph node/distant metastasis.
- Tumor resection using needle knife and hook knife ESD.
Main Results:
- Complete resection achieved in 100% of cases.
- No complications were reported.
- Mean operation time was 34.2 minutes, deemed clinically acceptable.
Conclusions:
- ESD is a feasible and efficacious treatment for selected rectal carcinoids (<10 mm).
- The described ESD strategy is safe and effective.
- Minimally invasive endoscopic resection is suitable for small rectal carcinoids.