A 45-year-old man is found to have a 1.5 cm rectal carcinoid tumor at 8 cm from the anal verge. Endoscopic ultrasound shows the tumor confined to the submucosa with no lymphovascular invasion. The most appropriate management is:
- A Endoscopic resection
- B Low anterior resection
- C Transanal excision ✓
- D Abdominoperineal resection
Correct answer: C. Transanal excision
Explanation
Rectal carcinoids 1-2 cm confined to the submucosa are managed by transanal full-thickness excision with clear margins. Endoscopic resection often leaves positive margins. Carcinoids less than 1 cm can be removed endoscopically, while those greater than 2 cm or with invasion require radical resection.
Reference: Cameron's Current Surgical Therapy, 14th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.