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[Diagnosis and treatment of early colorectal cancer]
1Department of General Surgery, Affiliated Tongren Hospital, Capital Medical University, Beijing 100730, China.
Objectives:
To study the diagnostic methods of early colorectal neoplasm before operation and to evaluate the value of these methods for selection.
Methods:
Fifteen patients with early colorectal neoplasms were examined pre-operatively by general colonoscopy to observe macroscopic appearance, by magnifying endoscopy to classify pit pattern type, and by endoscopic ultrasonography (EUS) to assess the penetrating depth of cancer invasion as well as regional lymph node metastases. According to these findings, diagnosis and clinical staging were made and proper treatment protocols were established.
Results:
The diameter of the tumors ranged from 1 to 6 cm. Most lesions were subpedunculate type (8/15, 53%). Eight cases belonged to pit pattern type III L + V (8/15, 53%). EUS showed mucosal cancer in 11 cases and submucosal cancer in 4. No lymph node metastasis was observed in any cases. Treatment methods included endoscopic polypectomy or endoscopic mucosa resection (EMR) in 6 cases, endo-surgery combined with open surgery in 2, and open surgery in 7. Pathological diagnosis showed mucosal carcinoma in 12 cases, submucosal carcinoma in 3. The accuracy of EUS was 93%.
Conclusions:
Magnifying endoscopy and EUS are useful for diagnosis of early colorectal cancer before operation, and correct preoperative staging of colorectal neoplasms is of significance in guiding treatment.