| [ Summary ] |
For the most part colorectal adenomas and early cancers are under 10mm in size. Ordinarily, there are three methods which may be employed,observation (with subseguent follow), endoscopic resection or no treatment at all. On the other hand, large, wide lesions, which are over 20mm in size, represent 2% of colorectal adenomas and early cancers, having a high potential for malignancy. Therefore, this study was carried out to clarify treatment choices. During the period from April 1985 to August 2000, we saw 337 cases, which were classified as colorectal adenomas or early cancers, over 20mm in size. We analyzed them for shape, pit patterns and pathological diagnosis. As a result, type IIIL pit patterns mainly suggested adenoma, and a few cases of mucosal cancer. Type IV was similar to type IIIL, but there were few cases of submucosal cancer. On the other hand, type VA usually suggested mucosal cancer, but the rate of submucosal cancer was 30% in the protruding type. Type VN mainly suggested submucosal cancer, especially massive invading cancer. With large lesions, we concluded that the adaptation of endoscopic therapy was appropriate for type IIIL and IV pit patterns, and we were careful concerning treatment of type VA lesions. It was necessary to surgically resected VN type lesions. |