Endoscopic large bowel polypectomy. Adequate treatment of some completely removed, minimally invasive lesions

Eighteen large bowel adenomas with invasion of the head or the stalk were removed by endoscopic polypectomy or by segmental resection at University Hospital, London, Ontario between 1973 and 1982. All were completely removed by histological criteria. All the patients were traced for an average follow-up period of 4.6 years. None had developed disseminated large bowel cancer. Adding these results to those in the literature, it appears that, provided there is not a high degree of anaplasia of the tumor or lymphatic or venous invasion, endoscopic polypectomy is adequate therapy for such adenomas. An endoscopic recheck of the site of removal after approximately 2 months may be worthwhile as a few local recurrences of benign tumor were reported, although not in the present series. The patients should be followed for life.