| Theme |
Management of large colorectal polyp --Indication and technique of endoscopic treatment |
| Title |
Endoscopic treatment for large polyps (>2cm) |
| Author |
Masahiro Igarashi |
Department of Internal Medicine, Kitasato University East Hospital |
| Author |
Kiyonori Kobayashi |
Department of Internal Medicine, Kitasato University East Hospital |
| Author |
Miwa Sada |
Department of Internal Medicine, Kitasato University East Hospital |
| Author |
Sigeru Yosizawa |
Department of Internal Medicine, Kitasato University East Hospital |
| Author |
Tomoe Katsumata |
Department of Internal Medicine, Kitasato University East Hospital |
| [ Summary ] |
We studied the clinico-pathological futures and methods of endoscopic treatment for colo-rectal lesions which were over 2cm in diameter (large polyps). The matter studied consisted of two hundred forty one lesions which were treated by endoscopic resection after being diagnosed as benign and classified as m cancers or sm slight cancers. The results were as follows :1) The incidence of large polyps was 1.2% in all lesions which were removed by endoscopic procedures. 2) Macroscopic type large polyps were classified as the polypoid type (62%), IIa type (16%) and nodule aggregating type (21%). 3) Piecemeal resection was often done for large polyps. The incidence rates were 10%, 61% and 76% in the polypoid type, IIa type and nodule aggregating type lesions, respectively. 4) Complications (hemorrhaging) occurred in 6.2% of all endoscopic treatments for large polyps. However, this complication was controlled by use of endoscopic hemostasis. Hemorrhaging was seen more often in piecemeal resection than in en bloc resection. 5) Remnant and local recurrence occurred in 3.1% of the polypoid type and in 6.9% of the IIa or nodule aggregating lesions. Remnant or local recurrence was often seen in cases of piecemeal resection.
It was concluded that piecemeal resection was useful for large polyps, however, it is necessary to carefully follow up with colonoscopy after endoscopic treatment. |