Endoscopic Studies of Small Rectal Carcinoid Tumor (Less than 10 mm in Diameter) -Especially, Effectiveness of Endoscopic Ultrasonography and 2 Channels Scope-

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  • 10mm以下の直腸カルチノイドの超音波内視鏡診断と内視鏡的ポリペクトミーにおける2チャンネルスコープの有用性についての検討

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Twenty-two cases (22 lesions) of small rectal carcinoid tumor (less than 10mm in diameter) were analyzed in order to evaluate the effectiveness of endoscopic ultrasonography in the diagnosis of carcinoid tumor invasion, and the usefulness of the 2 channels scope for endoscopic polypectomy of carcinoid tumors.<br> The results were as follows : <br> 1) Invasion of all tumors less than 10mm in diameter were limited to the submucosal layer, and lymphnode and distant metastasis were not found in our cases.<br> 2) Endoscopic ultrasonography (EUS) was performed in 11 cases to evaluate carcinoid tumor invasion. The ultrasonographic feature of carcinoid tumors were clearly shown as a hypoechoic mass in submucosal layer. Diagnostic accuracy of EUS of carcinoid tumor invasion was 100%, and no lymphnode swelling was detected by EUS in our cases.<br> 3) Fourteen cases (64%) were treated by endoscopic polypectomy and the other 8 cases (36%) were treated by surgical local excision.<br> 4) In endoscopically resected cases, 8 cases were treated by using the 2 channels scope, and other 6 cases were treated by using the 1 channel scope. According to correlation between frequency of invasion of carcinoid tumor at the resected margin and method of endoscopic polypectomy (2 channels scope vs 1 channel scope) , endoscopic polypectomy using the 2 channels scope was more useful therapeutic methods than the 1 channel scope.<br> Based on these results, we can evaluate that EUS is useful for diagnosis the small rectal carcinoid tumor invasion, and the 2 channels scope is valuable to complete resection of the small rectal carcinoid tumor by endoscopic polypectomy.

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