Tips and Tricks for Better Endoscopic Treatment of Colorectal Tumors: Usefulness of Cap and Band in Colorectal Endoscopic Mucosal Resection

Overview

Journal Clin Endosc

Date 2013 Oct 22

PMID 24143309

Citations 6

Authors

Seun Ja Park

Affiliations

Soon will be listed here.

Abstract

Endoscopic mucosal resection (EMR) is an endoscopic alternative to surgical resection of mucosal and submucosal neoplastic lesions. Prior to the development of knives, EMR could be performed with accessories to elevate the lesion. After the development of various knives, en bloc resection was possible without other accessories. So, recently, simple snaring without suction or endoscopic submucosal dissection using knife in the epithelial lesions such as adenoma or early mucosal cancer has been performed. However, for easy and complete resection of subepithelial lesions such as carcinoid tumor, a few accessories are needed. Complete resection of rectal carcinoid tumors is difficult to achieve with conventional endoscopic resection techniques because these tumors often extend into the submucosa. The rate of positive resection margin for tumor is lower in the group of EMR using a cap (EMR-C) or EMR with a ligation device (EMR-L) than conventional EMR group. EMR-C and EMR-L (or endoscopic submucosal resection with a ligation device) may be a superior method to conventional EMR for removing small rectal carcinoid tumors.

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References

Kobayashi K, Katsumata T, Yoshizawa S, Sada M, Igarashi M, Saigenji K . Indications of endoscopic polypectomy for rectal carcinoid tumors and clinical usefulness of endoscopic ultrasonography. Dis Colon Rectum. 2005; 48(2):285-91. DOI: 10.1007/s10350-004-0765-y. View

Morgan J, Thomas K, Lee-Robichaud H, Nelson R, Braungart S . Transparent cap colonoscopy versus standard colonoscopy to improve caecal intubation. Cochrane Database Syst Rev. 2012; 12:CD008211. PMC: 7105905. DOI: 10.1002/14651858.CD008211.pub3. View

Ng S, Tsoi K, Hirai H, Lee Y, Wu J, Sung J . The efficacy of cap-assisted colonoscopy in polyp detection and cecal intubation: a meta-analysis of randomized controlled trials. Am J Gastroenterol. 2012; 107(8):1165-73. DOI: 10.1038/ajg.2012.135. View

Park S, Kim H, Yoon K, Cho S, Lee W, Park C . Usefulness of cap-assisted colonoscopy during colonoscopic EMR: a randomized, controlled trial. Gastrointest Endosc. 2011; 74(4):869-75. DOI: 10.1016/j.gie.2011.06.005. View

Matsui K, Iwase T, Kitagawa M . Small, polypoid-appearing carcinoid tumors of the rectum: clinicopathologic study of 16 cases and effectiveness of endoscopic treatment. Am J Gastroenterol. 1993; 88(11):1949-53. View

Zhao Z, Zhang N, Ma S, Yang Z, Han X, Zhao Y . A comparative study on endoscopy treatment in rectal carcinoid tumors. Surg Laparosc Endosc Percutan Tech. 2012; 22(3):260-3. DOI: 10.1097/SLE.0b013e3182512e0f. View

Abe T, Kakemura T, Fujinuma S, Maetani I . Successful outcomes of EMR-L with 3D-EUS for rectal carcinoids compared with historical controls. World J Gastroenterol. 2008; 14(25):4054-8. PMC: 2725345. DOI: 10.3748/wjg.14.4054. View

Niimi K, Goto O, Fujishiro M, Kodashima S, Ono S, Mochizuki S . Endoscopic mucosal resection with a ligation device or endoscopic submucosal dissection for rectal carcinoid tumors: an analysis of 24 consecutive cases. Dig Endosc. 2012; 24(6):443-7. DOI: 10.1111/j.1443-1661.2012.01303.x. View

Kim Y, Lee S, Cheon J, Kim T, Lee Y, Kim W . [Efficacy of endoscopic resection for small rectal carcinoid: a retrospective study]. Korean J Gastroenterol. 2008; 51(3):174-80. View

10.

Lee S, Park S, Kim H, Ok K, Kim J, Jee S . Endoscopic resection for rectal carcinoid tumors: comparison of polypectomy and endoscopic submucosal resection with band ligation. Clin Endosc. 2012; 45(1):89-94. PMC: 3363123. DOI: 10.5946/ce.2012.45.1.89. View

11.

Kim H, Park S, Park M, Moon W, Kim S . Transparent-cap-fitted colonoscopy shows higher performance with cecal intubation time in difficult cases. World J Gastroenterol. 2012; 18(16):1953-8. PMC: 3337572. DOI: 10.3748/wjg.v18.i16.1953. View

12.

Westwood D, Alexakis N, Connor S . Transparent cap-assisted colonoscopy versus standard adult colonoscopy: a systematic review and meta-analysis. Dis Colon Rectum. 2012; 55(2):218-25. DOI: 10.1097/DCR.0b013e31823461ef. View

13.

Noda M, Kobayashi N, Kanemasa H, Tanahashi T, Wakabayashi N, Mitsufuji S . Endoscopic mucosal resection using a partial transparent hood for lesions located tangentially to the endoscope. Gastrointest Endosc. 2000; 51(3):338-43. DOI: 10.1016/s0016-5107(00)70365-8. View

14.

Shirouzu K, Isomoto H, Kakegawa T, Morimatsu M . Treatment of rectal carcinoid tumors. Am J Surg. 1990; 160(3):262-5. DOI: 10.1016/s0002-9610(06)80019-x. View

15.

Mashimo Y, Matsuda T, Uraoka T, Saito Y, Sano Y, Fu K . Endoscopic submucosal resection with a ligation device is an effective and safe treatment for carcinoid tumors in the lower rectum. J Gastroenterol Hepatol. 2008; 23(2):218-21. DOI: 10.1111/j.1440-1746.2008.05313.x. View

16.

Oshitani N, Hamasaki N, Sawa Y, Hara J, Nakamura S, Matsumoto T . Endoscopic resection of small rectal carcinoid tumours using an aspiration method with a transparent overcap. J Int Med Res. 2000; 28(5):241-6. DOI: 10.1177/147323000002800507. View

17.

Inoue H, Kawano T, Tani M, Takeshita K, Iwai T . Endoscopic mucosal resection using a cap: techniques for use and preventing perforation. Can J Gastroenterol. 1999; 13(6):477-80. DOI: 10.1155/1999/198230. View

18.

Jeon S, Lee J, Hong S, Kim T, Kim W, Cheon J . Feasibility of salvage endoscopic mucosal resection by using a cap for remnant rectal carcinoids after primary EMR. Gastrointest Endosc. 2011; 73(5):1009-14. DOI: 10.1016/j.gie.2010.12.029. View

19.

Kim H, Park S, Lee S, Park H, Song C, Park M . Efficacy of endoscopic submucosal resection with a ligation device for removing small rectal carcinoid tumor compared with endoscopic mucosal resection: analysis of 100 cases. Dig Endosc. 2012; 24(3):159-63. DOI: 10.1111/j.1443-1661.2011.01190.x. View