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Invasive colorectal adenomas: surgery versus colonoscopic polypectomy
1Gastroenterology Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Journal of Surgical Oncology
|January 1, 1990
Summary
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.
- 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.