Local surgical excision versus endoscopic resection for rectal carcinoid: A meta-analysis

Area of Science:

• Gastroenterology
• Surgical Oncology
• Gastrointestinal Endoscopy

Background:

• Optimal treatment strategies for early rectal carcinoids remain unclear.
• Evidence regarding the best local treatment for these tumors is limited.

Purpose of the Study:

• To conduct a meta-analysis determining the optimal local treatment for early rectal carcinoids.
• To compare local surgical excision with endoscopic resection for rectal carcinoids <20mm without adverse features.

Main Methods:

• Systematic literature search of PubMed, Cochrane, Medline, Ovid, SpringerLink, PMC, and Embase (Jan 2007-Apr 2017).
• Meta-analysis of seven studies involving 1056 patients comparing local surgical excision and endoscopic resection.
• Statistical analysis performed using Stata SE 12.0.

Main Results:

• Local surgical excision showed a higher complete resection rate (OR 5.837) but longer procedural time (SMD 1.757) than endoscopic resection.
• Recurrence rates and en bloc resection rates were comparable between both treatment groups.
• Post-operative complication differences were not clearly established.

Conclusions:

• Endoscopic resection is a potentially efficient treatment for rectal carcinoids ≤20mm without adverse features.
• Endoscopic resection provides comparable oncological safety to local surgical excision for these specific cases.