Abstract
Aim For many physicians who ordinarily treat patients with colonic diseases, colonoscopy is considered a prime study interest. Developments in colonoscopic equipment and methods have led to larger numbers of endoscopic diagnoses and treatments for colorectal neoplasms. The purpose of this investigation is to evaluate the efficacy and outcomes of endoscopic treatment for colorectal neoplastic lesions and the development of colorectal cancers after colonoscopic therapy. Materials and methods From September 1999 to May 2005, 19,815 consecutive colonoscopic examinations in 16,318 patients were gathered, totaling 9,534 endoscopic treatments for colorectal neoplasms. Macroscopic characteristics of the neoplasms were classified into protruded (N = 7,455), sessile (N = 1,569), lateral spreading tumor (N = 201), depressed lesions (N = 21), and flat lesions (N = 288). Snare polypectomy was conducted in 7,536 lesions, hot forceps removal in 1,545 lesions, and endoscopic mucosal resection in 353 lesions. Results Histological diagnoses were 8,333 neoplastic lesions (8,246 adenomas with low/high-grade dysplasia and 87 invasive adenocarcinomas) and 1,201 non-neoplastic lesions (1,186 hyperplastic and 15 inflammatory polyps). For the adenocarcinoma group, all had received further operations, while 73 surgical specimens discovered no residual tumors. Four perforations and 146 bleedings were found following endoscopic treatment. No procedure-related mortality was found and no recurrent malignancy was found after 6-71 months follow-up. Conclusion To lower the incidence and mortality of advanced colorectal cancer, endoscopic treatment for colorectal neoplasms is a simple and safe procedure.
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Kawamura YI, Sugamata Y, Yoshino K, Abo Y, Nara S, Sumita T, Setoyama R, Kiribuchi Y, Kawano N (1999) Endoscopic resection for submucosally invasive colorectal cancer. Is it feasible? Surg Endosc 13:224–227
Netzer P, Forster C, Biral R, Ruchti C, Neuweiler J, Stauffer E, Schonegg R, Maurer C, Husler J, Halter F, Schmassmann A (1998) Risk factor assessment of endoscopically removed malignant polyps. Gut 43:669–674
Kitamura K, Taniguchi H, Yamaguchi T, Sawai K, Takahashi T (1997) Clinical outcome of surgical treatment for invasive early colorectal cancer in Japan. Hepatogastroenterology 44:108–115
Kudo S, Kashida H, Nakajima T, Tamura S, Nakajo K (1997) Endoscopic diagnosis and treatment of early colorectal cancer. World J Surg 21:694–701
Kudo S (1993) Endoscopic mucosal resection of flat and depressed types of early colorectal cancer. Endoscopy 25:455–461
Tung S-Y, Wu C-S, Su M-Y (2001) Magnifying colonoscopy in differentiating neoplastic from nonneoplastic colorectal lesions. Am J Gastroenterol 96:2628–2632
Morson BC (1974) Evolution of cancer of the colon and rectum. Cancer 34:845–850
Schottenfeld D, Winawer SJ (1982) Large intestine. In: Schottenfeld D, Fraumani J Jr (eds) Cancer epidemiology and prevention. W.B. Saunders, Philadelphia, pp 703–727
Atkin WS, Morson BC, Cuzick J (1992) Long-term risk of colorectal cancer after excision of rectosigmoid adenomas. N Engl J Med 326:658–662
Deyhle P, Jargiader F, Jenny S (1973) A method of endoscopic electroresection of sessile colonic polyps [letter]. Endoscopy 5:38
Yokota T, Sugihara K, Yoshida S (1994) Endoscopic mucosal resection for colorectal neoplastic lesions. Dis Colon Rectum 37:1108–1111
Lieberman DA, Smith FW (1988) Frequency of isolated proximal colonic polyps among patients referred for colonoscopy. Arch Intern Med 148:473–475
Payne RA (1976) The incidence and clinical significance of rectal polyps. Ann R Coll Surg Engl 58:241–242
Chapui PH, Dent OF, Goulston KJ (1982) Clinical accuracy in diagnosis of small polyps using the flexible fiberoptic sigmoidoscopy. Dis Colon Rectum 25:669–672
Neale AV, Demers RY, Budev H, Scott RO (1987) Physician accuracy in diagnosing colorectal polyps. Dis Colon Rectum 30:247–250
Bond JH (1993) Is the small colorectal polyp clinically diminutive? Gastrointest Endosc 39:592–593
Lane N, Lev R (1963) Observation on the origin of adenomatous epithelium of the colon: serial section studies of minute polyps in familial polyposis. Cancer 16:751–754
Arthur JF (1968) Structure and significance of neopastic nodules in rectal mucosa. J Clin Pathol 21:735–743
Blue MG, Sivak MV, Achkar E, Matzen R, Stahl RS (1991) Hyperplastic polyps seen at sigmoidoscopy are markers for additional adenomas seen at colonoscopy. Gastroenterology 100:564–566
Opelka FG, Timmcke AE, Gathright JB, Ray J, Hicks TC (1992) Diminutive colonic polyps: an indication for colonoscopy. Dis Colon Rectum 35:178–181
Kasita M, Cantero D, Okita K (1993) Endoscopic diagnosis and resection for flat adenoma with severe dysplasia. Am J Gastroenterol 88:1421–1423
Su M-Y, Ho Y-P, Chen P-C, Chiu C-T, Wu C-S, Hsu C-M, Tung S-Y (2004) Magnifying endoscopy with indigo carmine contrast for differential diagnosis of neoplastic and nonneoplastic colonic polyps. Dig Dis Sci 49:1123–1127
Waye JD (1993) Management of complications of colonoscopic polypectomy. Gastroenterologist 1:158–164
Jentschura D, Raute M, Winter J (1994) Complications in endoscopy of lower gastrointestinal tract: therapy and prognosis. Surg Endosc 8:672–676
Yokota T, Sugihara K, Yoshida S (1994) Endoscopic mucosal resection for colorectal neoplastic lesions. Dis Colon Rectum 37:1108–1111
Muto T, Bussey HJR, Morson BC (1975) The evaluation of cancer of the colon and rectum. Cancer 36:2251–2270
Day DW, Morson BC (1978) The pathogenicy of colorectal cancer. WB Saunders, Philadephia, pp 58–71
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Su, MY., Hsu, CM., Lin, CJ. et al. Endoscopic Treatment of Colorectal Neoplasms: A Simple and Safe Procedure to Lower the Incidence of Colorectal Cancers. Dig Dis Sci 53, 1297–1302 (2008). https://doi.org/10.1007/s10620-008-0236-8
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DOI: https://doi.org/10.1007/s10620-008-0236-8