ENDOSCOPIC DIAGNOSIS AND RESECTION TREATMENT FOR FLAT ADENOMA WITH SEVERE DYSPLASIA

In a prospective study from 1988 to 1991, we discovered 31 flat colon adenomas in 29 patients and performed endoscopic resection of 27 of th ese lesions, using the strip biopsy technique. All of these lesions we re safely and completely resected even in the thin walls of the colon. All 27 lesions were histologically flat adenomas confined to the muco sa, with a maximum diameter of 31-20 mm. Thirteen were identified as s evere dysplasia, three as moderate dysplasia, and 11 as mild dysplasia . These lesions were more clearly defined after they were sprayed with indigo carmine endoscopically. The 13 flat adenomas with severe dyspl asia were morphologically slightly depressed red lesions with elevatio n of the surrounding mucosa (six lesions) and flat round red lesions w ith no changes in the surrounding mucosa (seven lesions). Due to the h igh incidence of severe dysplasia found in flat adenomas, removal usin g strip biopsy is recommended.