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Invasive colorectal adenomas: surgery versus colonoscopic polypectomy.

A Pines1, L Bat, E Shemesh

  • 1Gastroenterology Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel.

Journal of Surgical Oncology
|January 1, 1990
PubMed
Summary
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Colonoscopic polypectomy effectively removes invasive pedunculated polyps when margins are clear. Surgery is recommended for invasive sessile polyps due to higher-stage cancer risk.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Colorectal Surgery

Background:

  • Colorectal adenomatous polyps can become invasive.
  • Colonoscopic polypectomy is a common treatment for polyps.

Purpose of the Study:

  • To evaluate the efficacy of colonoscopic polypectomy for invasive colorectal adenomatous polyps.
  • To compare outcomes for pedunculated versus sessile invasive polyps.

Main Methods:

  • Retrospective analysis of 6,426 colonoscopies (1978-1987).
  • Identification and classification of 66 invasive colorectal adenomatous polyps.
  • Review of surgical resection and follow-up data.

Main Results:

  • Colonoscopic polypectomy completely removed invasive pedunculated polyps in all cases.

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  • Invasive sessile polyps were frequently Dukes' B or C carcinoma.
  • No local recurrence observed in unoperated pedunculated polyp patients with clear margins.
  • Conclusions:

    • Colonoscopic polypectomy is sufficient for invasive pedunculated polyps with clear resection margins.
    • Surgical resection is advised for all invasive sessile polyps.
    • Histological confirmation of clear margins is crucial for pedunculated polyp management.