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Large colorectal polyps: colonoscopy, pathology, and management.
E J Gyorffy1, J S Amontree, C M Fenoglio-Preiser
1Division of Gastroenterology, University of New Mexico School of Medicine, Albuquerque.
The American Journal of Gastroenterology
|August 1, 1989
Summary
Colonoscopic polypectomy is effective for most large colorectal polyps (≥3.0 cm). However, colectomy may be needed for incomplete removal or invasive cancer not curable by colonoscopy.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Colorectal Surgery
Background:
- Large colorectal polyps (≥3.0 cm) pose challenges for complete removal and cancer assessment.
- Determining the efficacy of colonoscopic polypectomy for these large lesions is crucial for patient management.
Purpose of the Study:
- To evaluate the oncologic and technical success of colonoscopic polypectomy for large colorectal polyps (≥3.0 cm).
Main Methods:
- Retrospective review of 48 large colorectal polyps (≥3.0 cm) in 46 patients between 1984 and 1987.
- Analysis of polyp histology, treatment method (colonoscopic polypectomy vs. colectomy), and patient outcomes.
Main Results:
- Of 48 large polyps, 20 were benign, 20 had noninvasive carcinoma, and 8 had invasive carcinoma.
- Colonoscopic polypectomy was performed on 32 polyps; 4 patients required colectomy due to incomplete excision or invasive cancer.
- Two submucosal invasive cancers were successfully removed colonoscopically; 16 polyps were surgically removed, primarily right-sided lesions.
Conclusions:
- Colonoscopic polypectomy is oncologically and technically successful for the majority of large colorectal polyps.
- Colectomy is necessary for a subset of large polyps with incomplete removal or invasive cancer unsuitable for colonoscopic excision.