Endoscopic submucosal dissection versus transanal local excision for rectal carcinoid: a comparative study

Area of Science:

• Gastroenterology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Rectal carcinoid tumors are rare neuroendocrine neoplasms.
• Treatment decisions depend on tumor size, location, and characteristics.
• Minimally invasive techniques are increasingly utilized for rectal tumor resection.

Purpose of the Study:

• To compare short-term clinical outcomes of endoscopic submucosal dissection (ESD) versus transanal local excision (TLE) for rectal carcinoid tumors.
• To evaluate surgical parameters, postoperative recovery, and oncologic outcomes.
• To identify optimal treatment strategies based on tumor characteristics.

Main Methods:

• Retrospective comparison of 31 patients treated with ESD and 23 patients treated with TLE between 2007 and 2012.
• Matched cohort analysis based on tumor characteristics.
• Evaluation of operative time, resection success, complications, and follow-up oncologic outcomes.

Main Results:

• Tumors treated with TLE were significantly larger (1.1 cm vs 0.8 cm).
• En bloc resection rates were high for both ESD (97%) and TLE (100%).
• ESD had significantly shorter operation times (12.2 min vs 40.0 min) and fewer complications (e.g., acute urinary retention). No recurrence was observed in either group.

Conclusions:

• Endoscopic submucosal dissection demonstrates superior short-term outcomes for rectal carcinoid tumors <1 cm, including faster recovery and lower morbidity.
• Transanal local excision remains a viable option, particularly for scar-embedded rectal carcinoid tumors.
• Further research may refine treatment algorithms for rectal carcinoid tumors.