| Theme |
Can we change to treat for diminutive colorectal polyp ? |
| Title |
Review of Resect-and-Discard strategies |
| 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. |