INTESTINE Vol.20 No.5(6)

Theme Cold polypectomy : Merits and demerits
Title Management of polyps less than 10 mm : Data from the Japan Polyp Study
Publish Date 2016/09
Author Hiroaki Ikematsu Department of Gastroenterology, Endoscopy Division, National Cancer Center Hospital East
Author Takahisa Matsuda Cancer Screening Center / Endoscopy Division, National Cancer Center Hospital
Author Yasushi Sano Sano Hospital
Author Yasushi Oda Oda GI Endoscopy and Gastroenterology Clinic
Author Kazuhiro Kaneko Department of Gastroenterology, Endoscopy Division, National Cancer Center Hospital East
Author Shin-ei Kudo Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Hirokazu Taniguchi Pathology and Clinical Laboratory Division, National Cancer Center Hospital
Author Kinichi Hotta Division of Endoscopy, Shizuoka Cancer Center
Author Takahiro Fujii TF Clinic
Author Japan Polyp Study Workgroup Japan Polyp Study Workgroup
[ Summary ] The endoscopic removal of adenomatous polyps reduces the incidence of colorectal cancer and the associated mortality. During colonoscopy, small and diminutive colorectal polyps are commonly encountered and are treated using several techniques. We investigated the treatment types and complications related to small polyps (less than 10 mm) based on the initial total colonoscopy data of the Japan Polyp Study. A total of 5,168 small colorectal polyps (3,827 diminutive colorectal polyps of ≤5 mm, and 1,341 small colorectal polyps of 6-9 mm) were detected and removed endoscopically. For diminutive colorectal polyps, treatment rates with cold forceps polypectomy, hot biopsy, polypectomy, and endoscopic mucosal resection (EMR) were 12.2 %, 45.1 %, 36.5 %, and 6.1 %, respectively, and for small colorectal polyps, the treatment rates with these four techniques were 0.1 %, 35.4 %, 41.7 %, and 13.8 %, respectively. For many depressed lesions and early colorectal cancers, EMR was indentified as the treatment of choice. The complication rate associated with colorectal polyps less than 10 mm was 0.5 % (26/5,168). Of these 26 cases, 1 delayed perforation due to hot biopsy was noted.
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