| Endoscopic Resection for Rectal Carcinoid Tumor: Efficacy and Clinical Results of Follow-up |
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Gwang Un Kim, Byong Duk Ye, Jeong-Sik Byeon, Hwan Sung Park, Tae Jin Ok, Dong-Hoon Yang, Kee Wook Jung, Kyung Jo Kim, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim |
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Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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| 직장 유암종의 내시경 절제: 효능과 추적 임상경과 |
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김광운, 예병덕, 변정식, 박환성, 옥태진, 양동훈, 정기욱, 김경조, 명승재, 양석균, 김진호 |
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울산대학교 의과대학 내과학교실, 서울아산병원 소화기내과 |
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| Abstract |
Background/Aims
With the growing volume of screening colonoscopies, the incidence of rectal carcinoids and the number of endoscopic resections for rectal carcinoids are also increasing. However, the prognosis including recurrence and metachronous lesions after endoscopic resection is unclear. Methods: The medical records of 255 patients who had undergone endoscopic resection for rectal carcinoids between October 1999 and April 2010 were retrospectively reviewed. Results: The number of males was 150 (58.8%), and the mean age was 54.1 years (range, 27-85 years). Mean tumor size was 6.9 mm. In total, 162 cases (63.5%) were treated with endoscopic mucosal resection and 93 (36.5%) were treated with endoscopic submucosal dissection. Although endoscopic complete resections were achieved in all cases, the histological examination showed 47 cases with a positive resection margin (18.4%) and three with lymphovascular invasion (1.2%). In the 54 patients with a free resection margin, who were followed for more than 12 months, abdominopelvic computed tomography and endoscopy did not show recurrence after a median of 30.5 and 36 months, respectively. Three patients with lymphovascular invasion did not show recurrence during follow-up period of 13, 30, and 37 months, respectively. Metachronous rectal carcinoids were detected in four patients at 23, 58, 61, and 89 months, respectively, after initial endoscopic resection, leading to a second endoscopic treatment. Conclusions: Small rectal carcinoids completely resected grossly and pathologically without lymphovascular invasion appear to have low probability of short-term recurrence. However, considering the slow growth rate of carcinoids, long-term follow-up for recurrence and metachronous carcinoids is required. (Intest Res 2011;9:217-224) |
| Key Words:
Carcinoid Tumor, Rectum, Colonoscopy, Prognosis |
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