| Theme |
Update in management of colitic cancer |
| Title |
Management of dysplasia |
| Author |
Masahiro Igarashi |
Division of Endoscopy, Cancer Institute Ariake Hospital |
| Author |
Naoyuki Uragami |
Department of Gastroenterology, Cancer Institute Ariake Hospital |
| Author |
Akiko Chino |
Department of Gastroenterology, Cancer Institute Ariake Hospital |
| Author |
Daishi Ogawa |
Division of Endoscopy, Cancer Institute Ariake Hospital |
| Author |
Teruhito Kishihara |
Division of Endoscopy, Cancer Institute Ariake Hospital |
| [ Summary ] |
We reviewed the management of dysplasia associated with ulcerative colitis. Macroscopic features were important in deciding on treatment options. In patients with polypoid low grade dysplasia (LGD) and single lesions we recommended follow-ups after endoscopic resection. In LGD cases with multiple lesions or incompletely removed lesions we recommended colectomy. In patients with flat LGD we generally recommended colectomy. If the patients refuse colectomy, repeated surveillance examinations should be undertaken at short intervals (of 6 months or less). If flat LGD is detected during repeated colonoscopy and biopsy, colectmies should be performed. In patients with flat high-grade dysplasia (HGD) we recommended colectomy except in cases with polypoid HGD and single lesions, in which complete removal was accomplished by endoscopically.
It was concluded that patients with LGD or HGD found in an endoscopically nonresectable lesions and HGD found in flat mucosa are candidates for colectomies. |