Invasive colorectal adenomas: Surgery versus colonoscopic polypectomy

✍ Scribed by Amos Pines; Leon Bat; Eliahou Shemesh; Elaine Ron; Ada Horowitz; Angela Chetrit; Jose J. Bubis

• Book ID: 102440528
• Publisher: John Wiley and Sons
• Year: 1990
• Tongue: English
• Weight: 305 KB
• Volume: 43
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/jso.2930430114

✦ Synopsis

Of 6,426 colonoscopies performed in [1978][1979][1980][1981][1982][1983][1984][1985][1986][1987] 66 invasive colorectal adenomatous polyps were removed in 58 examinations. The study group included 36 (62%) men and 22 (38%) women with an age range of 42-96 years. Forty-three patients had invasive pedunculated polyps and 15 had invasive sessile polyps. Following the colonoscopic polypectomy , secondary surgical resection was done in 19 patients with pedunculated polyps and in 13 patients with sessile polyps. The operative specimens showed that the colonoscopic polypectomy removed the entire cancerous focus in all patients with pedunculated polyps, including those with stalk invasion. In contrast, most cases with sessile polyps turned out on operation to be Dukes' B or C carcinoma. Follow-up (mean 4.4 years) was available for 53 (93%) patients: none of 24 unoperated patients with pedunculated polyps suffered from local recurrence. We conclude that colonoscopic polypectomy is sufficient for invasive pedunculated polyps, provided that histology shows that the resection margins are free of tumoral cells. Surgery is recommended for all invasive sessile polyps.