| Theme | Can we change to treat for diminutive colorectal polyp ? | |
|---|---|---|
| Title | Endoscopic diagnosis and treatment for diminutive colorectal tumors | |
| Publish Date | 2014/05 | |
| Author | Shiro Oka | Department of Endoscopy, Hiroshima University Hospital |
| Author | Shinji Tanaka | Department of Endoscopy, Hiroshima University Hospital |
| Author | Koichi Nakadoi | Department of Gastroenterology and Metabolism, Hiroshima University Hospital |
| Author | Naoki Asayama | Department of Gastroenterology and Metabolism, Hiroshima University Hospital |
| Author | Kenjiro Shigita | Department of Gastroenterology and Metabolism, Hiroshima University Hospital |
| Author | Nana Hayashi | Department of Gastroenterology and Metabolism, Hiroshima University Hospital |
| Author | Soki Nishiyama | Department of Gastroenterology and Metabolism, Hiroshima University Hospital |
| Author | Motomi Terasaki | Department of Gastroenterology and Metabolism, Hiroshima University Hospital |
| Author | Kazuaki Chayama | Department of Gastroenterology and Metabolism, Hiroshima University Hospital |
| [ Summary ] | The vast majority of diminutive (- 5 mm) colorectal tumors exhibit a of a very low prevalence of advanced neoplasia. A predict-resect-and-discard policy has recently been proposed in western countries. The histology of some diminutive colorectal lesions reveals carcinomas but not adenomas, however the frequency is relatively low. Clarifying the endoscopic features of diminutive colorectal carcinomas (CRC) with submucosal invasion during colonoscopy is important to manage diminutive lesions. It is also important to confirm depressed areas on the tumor surface using indigocarmine dye spraying and to do magnifying observation when diminutive colorectal carcinoma is suspected. Our data showed that all cases of diminutive CRC were completely resected with en bloc endoscopic resection (ER) after magnifying observation. There were no cases of lymph node metastasis. Therefore, diminutive submucosal invasive CRC with submucosal invasion is thought to be an indication for ER to perform excisional biopsies. Further studies of the Japanese population are required to introduce the use of cold biopsies, cold snare polypectomies, or to implement the predict-resect-and-discard policy for diminutive colorectal lesions in this country. | |