| Theme | Can we change to treat for diminutive colorectal polyp ? | |
|---|---|---|
| Title | The appropriateness of "Resect and Discard trial" -- A consideration based on a case series of the diminutive submucosal invasive colorectal cancers | |
| Publish Date | 2014/05 | |
| Author | Kinichi Hotta | Division of Endoscopy, Shizuoka Cancer Center |
| Author | Kenichiro Imai | Division of Endoscopy, Shizuoka Cancer Center |
| Author | Yuichiro Yamaguchi | Division of Endoscopy, Shizuoka Cancer Center |
| Author | Noboru Kawata | Division of Endoscopy, Shizuoka Cancer Center |
| Author | Kohei Takizawa | Division of Endoscopy, Shizuoka Cancer Center |
| Author | Naomi Kakushima | Division of Endoscopy, Shizuoka Cancer Center |
| Author | Masaki Tanaka | Division of Endoscopy, Shizuoka Cancer Center |
| Author | Hiroyuki Matsubayashi | Division of Endoscopy, Shizuoka Cancer Center |
| Author | Hiroyuki Ono | Division of Endoscopy, Shizuoka Cancer Center |
| [ Summary ] | The Detect InSpect ChAracterise Resect and Discard (DISCARD) trial has proposed a new concept for managing colorectal polyps which does not require pathological examinations. It is less time consuming and more cost-effective. Furthermore, the American Society of Gastrointestinal Endoscopy published their findings : Preservation and Incorporation of Valuable Endoscopic Innovations recommending real-time endoscopic assessment of the histology of diminutive colon polyps. These recommendations indicate that colorectal polyps of ≤5 mm be resected and discarded without pathologic assessment. They also state endoscopic findings in combination with histopathologic findings should be in ≥90 % agreement when assigning post-polypectomy surveillance intervals, compared to those assigned when pathologic assessment is considered. There were eight diminutive submucosal invasive colorectal cancers. Five protruded type cancers were initially diagnosed as adenomas before treatment and resected endoscopically, and then diagnosed as non-polypoid growth type. We should pay attention to diminutive and protruded type submucosal invasive cancers, when adopting the DISCARD policy. | |