| Theme | Current Endoscopic Treatment for Colorectal Tumors | |
|---|---|---|
| Title | Endoscopic Treatment for Pedunculated Colonic Polyps over 20 mm in Diameter | |
| Publish Date | 2014/02 | |
| Author | Hiroyuki Ozasa | Kurume Coloproctology Center |
| Author | Yasumi Araki | Kurume Coloproctology Center |
| Author | Toshihiro Noake | Kurume Coloproctology Center |
| Author | Kazutsugu Iwamoto | Kurume Coloproctology Center |
| Author | Masahiro Takano | Kurume Coloproctology Center |
| Author | Kazuo Shirouzu | Department of Surgery, Kurume University School of Medicine |
| [ Summary ] | Although colorectal neoplasms larger than 20 mm in diameter occur infrequently, the associated incidence of cancer and of invasion into the submucosal layer are high. Pedunculated polyps (Ip-type) larger than 20 mm in diameter can be resected en bloc safely and easily with snare polypectomy. Detachable snares are effective to prevent hemorrhaging after endoscopic resection. However, during endoscopy and prior to endoscopic resection, the polyp stalk should be closely examined. If this stalk appears thick, expansive and hard, then surgical treatment should be considered. There is generally no lymph node metastasis, so Ip-type early invasive cancer (head invasion) without lymphovascular invasion can generally be treated with endoscopic resection alone. | |