[Endoscopic treatment of early cancer of the large bowel]

The indication for endoscopic polypectomy as treatment of early cancer of the large bowel was studied in 766 polypectomized specimens which had been obtained over a period of 11 years (1973 to 1983) at the Cancer Institute Hospital, Tokyo and the following results were obtained. There were 15 lesions with remaining cancer at the polypectomy site. Thirteen cases of them were invasive cancer with massive submucosal invasion which could not be removed completely by polypectomy. There were 3 recurrent cancers: one of them had remained in the mucosal membrane, but the other two had developed into advanced cancer. The polypectomized specimens of these advanced cancers were diagnosed as invasive cancer with marked mucus production. In both cases there was massive submucosal invasion. Strict follow-up with short intervals is required in order to detect local recurrent cancer if prompt operation cannot be done in those cases which show invasive cancer. Endoscopic polypectomy is not indicated for lesions measuring larger than 18 mm in the largest diameter because there often occurred deep ulcer (Ul-III and IV) which indicated that colonic wall was liable to perforation.