Endoscopic treatment of colorectal polyps and early cancer

To analyze the efficacy and outcome of colonoscopic resection for colorecta l neoplastic lesions, we retrospectively reviewed 338 colorectal lesions fr om 232 patients regarding the clinical profiles, colonoscopic findings, his tological findings, complications, and outcome. Morphologically, these lesi ons were classified into three categories: pedunculated (n = 140), sessile (n = 176); and flat (n = 22). Histological findings of lesions included ade noma (n = 248), carcinoma in situ (n = 17), submucosal carcinoma (n = 2), h yperplastic polyp (n = 57), and inflammatory polyp (n = 14). Neoplastic les ions are generally larger than nonneoplastic lesions (chi (2) test, P < 0.0 5). The incidence of carcinoma was 5.6% of 338 resected lesions. The rate o f cancer or high-grade dysplasia in flat polyps was greater than in peduncu lated and sessile polyps (13.6 vs 4.54 vs 5.71%; P < 0.05). There were no p erforations or deaths after colonoscopic treatment, and only mild bleeding occured in two patients. To date, 19 patients with early colorectal cancer were treated successfully by endoscopy with no recurrence or metastasis. To reduce the incidence and mortality of colorectal cancer, colonoscopic rese ction is a simple and safe procedure for removing neoplastic lesions. Detai led histological examinations are essential to decide the indications of su rgery.