Oct 11, 2003

Long-term follow-up of large flat colorectal tumors resected endoscopically

Endoscopy
S HigakiK Okita

Abstract

When a large flat colorectal tumor is excised by piecemeal endoscopic resection, it is not possible to obtain suitable specimens for histopathological examination to assess whether the resection has been complete. We prospectively analysed follow-up colonoscopy examinations of endoscopic polypectomy resection sites for residual lesions. A total of 24 patients with large flat colorectal tumors were treated using an endoscopic submucosal saline injection technique. The resection site was prospectively examined for residual lesions using a magnifying colonoscope, at 3, 6, 12 and 24 months postoperatively. None of the 5 patients who underwent en bloc resection exhibited residual lesions postoperatively. Of the 19 patients who underwent piecemeal resection, one died of an asthma attack and 18 were followed up. Residual lesions were detected in four of these 18 patients (three adenomas and one cancer), which were resected endoscopically. When the tumor was resected endoscopically en bloc and was judged histologically to be completely resected, residual lesions were not detected at follow-up. However, residual lesions were detected in 22.2 % of patients 3 months after initial resection when polyps were resected piecemeal. After treatm...Continue Reading

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Mentioned in this Paper

Endoscopy (Procedure)
Polyps
Submucosal Route of Drug Administration
Colorectal Neoplasms
Adenoma
Colonoscopic Surgical Procedures
Asthma Attack
Carcinoma, Cribriform
Colonic Polyps
Colonoscopy Through Stoma; Diagnostic, With or Without Collection of Specimen(S) by Brushing or Washing (Separate Procedure)

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