| Theme |
Recent advance in diagnosis and management of colorectal tumors associated with inflammatory bowel disease |
| Title |
Management and follow up of ulcerative colitis associated colorectal neoplasia |
| Author |
Nobuyuki Hida |
Division of Internal Medicine, Department of Inflammatory Bowel Disease, Hyogo College of Medicine |
| Author |
Shiro Nakamura |
Division of Internal Medicine, Department of Inflammatory Bowel Disease, Hyogo College of Medicine |
| [ Summary ] |
The natural history of dysplasia in patients with ulcerative colitis (UC) is poorly understood, method to best manage it remain controversial. Traditionally, the discovery of endoscopically visible dysplasia, so called "dysplasia associated lesions or mass (DALM)" led to colectomies. However, DALM can be very confusing as indications not specific. The recently published SCENIC consensus statement recommended abandoning the term "DALM", and developed a new set of terminology for UC associated neoplastic lesions. The SCENIC panelists also recommend that surveillance colonoscopies rather than colectomies be recommended for removal of endoscopically resectable polypoid dysplasia with distinct borders, although the available evidence is of very low quality. Patients with dysplasia should either decide to undergo colectomies, endoscopic resection, or close colonoscopic follow-ups, depending on individual situations such as the form and degree of dysplasia. |