| Theme | Can we change to treat for diminutive colorectal polyp ? | |
|---|---|---|
| Title | Review of Resect-and-Discard strategies | |
| Publish Date | 2014/05 | |
| Author | Mineo Iwatate | Gastrointestinal Center, Sano Hospital |
| Author | Yasuko Hisano | Gastrointestinal Center, Sano Hospital |
| Author | Hidekazu Kosaka | Gastrointestinal Center, Sano Hospital |
| Author | Santa Hattori | Gastrointestinal Center, Sano Hospital |
| Author | Wataru Sano | Gastrointestinal Center, Sano Hospital |
| Author | Noriaki Hasuike | Gastrointestinal Center, Sano Hospital |
| Author | Akihiro Ichiyanagi | Gastrointestinal Center, Sano Hospital |
| Author | Taro Ikumoto | Gastrointestinal Cancer Center, Sano Hospital |
| Author | Masahito Kotaka | Gastrointestinal Cancer Center, Sano Hospital |
| Author | Yasushi Sano | Gastrointestinal Center, Sano Hospital |
| Author | Takahiro Fujimori | Diagnostic Pathology Center, Shinko Hospital |
| [ Summary ] | Because of a shortage of pathologists, a new concept concerning saving formal histopathology for small polyps along with real-time endoscopic diagnosis was developed in western countries. If we diagnose a small polyp as being an adenoma or a hyperplastic polyp with a high confidence, we should resect and discard it as being an adenoma, or not resect it if it is determined to be a hyperplastic polyp. In cases where we can not diagnose the condition of small polyps with a high confidence, we must resect them and submit them for formal pathology as usual. In 2011, the American Society of Gastrointestinal Endosocopy proposed key thresholds to be as follows (>90 % agreement in determining postpolypectomy surveillance intervals and >90 % negative predictive value). Their statement termed Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI) applys to clinical realtime endoscopic assessment of diminutive colorectal polyps. | |