Abstract
Eight rectal carcinoids have been detected for the last 7 years. Seven cases were treated by endoscopic polypectomy or local resection, which were sessile or semipedun-culated polypoid lesions measuring 5 to 14 mm and limited within submucosal layer except for one case measuring 12 mm involving muscular layer. Additional operations were done in 4 cases because tumor cells were found at the margin of resected specimen, but not found at the surgical specimens. Endoscopic follow-up examination revealed no recurrence for 2 to 6 years after treatment. On the basis of these results and literature review, one of the guidelines for treatment of rectal carcinoid is proposed. 1) Endoscopic polypectomy for the lesions measuring less than 10 mm, and local resection for those measuring 11 to 19 mm should be performed. When their histological type is D type of Soga's classification or marked lymphatic and/or venous invasion are recognized, not to mention muscular inva-sion, radical operation should be added. 2) When tumor cells were present at the resected margin of polypectomized specimen, additional local resection is recommended to decide the indication of radical operation by confirming the presence of residual tumor cells and depth of invasion. Additional laser irradiation or electrocoagulation is successful proce-dure for the lesion less than 5 mm. 3) When the lesion is over 20mm, with central depression or ulceration and the cases in which invasion over muscular layer or metastases to the regional lymph nodes are suspected by digital examination or trans-rectal EUS, radical operation should be performed.
