| Endoscopic removal of large colorectal polyps: prevention of unnecessary surgery? | |
| | |
MedLine Citation:
|
PMID: 12626909 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
PURPOSE: Because of the potential risk of malignancy and technical difficulties in achieving complete removal, large colorectal polyps represent a special problem for the endoscopist. The aim of this study was to evaluate the capabilities and risks of endoscopy in complete removal of large colorectal polyps. METHODS: Endoscopic polypectomy of 186 colorectal polyps larger than 3 cm in diameter (range, 3-13 cm) was performed; 141 were sessile and 45 pedunculated. Most of the polyps were located in the rectum (n = 88), sigmoid (n = 63), and cecum (n = 9). The remaining adenomas were situated in other parts of the colon. Sessile polyps were removed using the piecemeal technique. RESULTS: Histology results showed an adenoma in 167 cases, and invasive carcinoma was present in the adenoma in 19 patients. Of the adenomas, 29 were tubulous, 118 tubulovillous, and 20 villous; adenoma with severe dysplasia was found in 49 cases. Complete endoscopic removal was achieved in all sessile and pedunculated polyps. None of the patients with invasive carcinoma who underwent surgical resection (n = 10) had any evidence of tumor in the resected specimen. Bleeding occurred in 4 patients after polypectomy (2 percent). Perforation occurred in 1 patient (0.5 percent), who had an invasive carcinoma of the cecum. There was no procedure-related mortality. During a mean follow-up period of 40 (range, 3-87) months, 6 patients presented with recurrence of a benign adenoma (3 percent), which was treated endoscopically, and 1 patient presented with a recurrent invasive carcinoma, which was treated surgically. CONCLUSIONS: Endoscopic polypectomy is a safe and effective method of treating large colorectal polyps. |
| | |
Authors:
|
J Marek Doniec; Mathias S Löhnert; Bodo Schniewind; Frank Bokelmann; Bernd Kremer; Horst Grimm |
Related Documents
:
|
22041239 - Increased use of pre-operative imaging and laparoscopy has no impact on clinical outcom... 21633309 - Congenital anomaly of low insertion of cystic duct: endoscopic retrograde cholangiopanc... 21770679 - Usefulness of endoscopic ultrasonography in the clinical suspicion of biliary disease. 21969189 - Laparoscopic surgery for rectal cancer: review of published literature 2000-2009. 9419909 - Acute pseudo-obstruction of the colon (ogilvie's syndrome): advances in management. 3947879 - On-table lavage to achieve safe restorative rectal and emergency left colonic resection... 6936509 - Long-term experience with simultaneous movement of the upper and lower jaw. 11534689 - Gamma knife radiosurgery of acoustic neurinomas. 19440139 - Achilles tendinopathy. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Diseases of the colon and rectum Volume: 46 ISSN: 0012-3706 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2003 Mar |
Date Detail:
|
Created Date: 2003-03-10 Completed Date: 2003-04-24 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: United States |
Other Details:
|
Languages: eng Pagination: 340-8 Citation Subset: IM |
Affiliation:
|
Department of General and Thoracic Surgery, University Hospital, Christian Albrechts University, Arnold-Heller-Strasse 7, 24105 Kiel, Germany. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adenocarcinoma
/
pathology,
surgery* Adenomatous Polyps / pathology, surgery* Adult Aged Aged, 80 and over Colectomy / utilization* Colonic Polyps / pathology, surgery Colonoscopy / adverse effects, methods* Female Humans Intestinal Polyps / pathology, surgery* Intestine, Large Male Neoplasm Recurrence, Local* Postoperative Hemorrhage Unnecessary Procedures* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Prognostic significance of lateral lymph node micrometastases in lower rectal cancer: an immunohisto...
Next Document: Virtual reality: new method of teaching anorectal and pelvic floor anatomy.