| Theme |
Reappraisal of Colorectal Protruded and Flat Lesions Which are Encountered During Endoscopy |
| Title |
Diagnosis for Early Colorectal Carcinomas -- Conventional Colonoscopy |
| Author |
Yusuke Saitoh |
Digestive Disease Center, Asahikawa City Hospital |
| Author |
Masaki Taruishi |
Digestive Disease Center, Asahikawa City Hospital |
| Author |
Ken-ichiro Ozawa |
Digestive Disease Center, Asahikawa City Hospital |
| Author |
Shunsuke Nakajima |
Digestive Disease Center, Asahikawa City Hospital |
| Author |
Ryuji Sugiyama |
Digestive Disease Center, Asahikawa City Hospital |
| Author |
Motoya Tominaga |
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical College |
| [ Summary ] |
When lesions are detected and suspected of being carcinomas, discrimination between PG (polypoid growth) types or NPG (non polypoid growth) types is important to determine invasion depth. This may be accomplished by use of dye spray methods. Important colonoscopic findings for the determination of therapeutic strategies are elucidated. Objective colonoscopic findings for SM-massive cancers are as follows；presence of "expanded appearance", "stiffness of the lesion", "coarse or uneven surface", or "converging folds leading toward the tumor". "Deformities or poor extension surrounding the tumor" may be observed, in polypoid type carcinomas. The presence of "expanded appearance" or "stiffness of the lesion may be seen also. "Coarse or uneven surfaces", "deep or irregular depressed surfaces" as well as deep red surfaces, "surface strong redness" may also be observed. "Converging folds, leading toward the tumor", "deformities or poor extension surrounding the tumor" or "table-like protrusions from the lesion" may be observed in flat and depressed type lesions. If no colonoscopic finding are detected in the lesion with use of the dye spray method, endoscopic resection is recommended. If one or more of the above colonoscopic findings are detected, surgical procedures should be considered. |