How can colorectal neoplasms be treated during colonoscopy?
OBJECTIVE
For many physicians who ordinarily treat patients with colonic diseases, colonoscopy is considered a prime study interest. Developments in colonoscopic equipment and methods have led to a large number of endoscopic diagnoses and treatment for colorectal neoplasms. The purpose of this investigation is to evaluate the efficacy and outcomes of endoscopic treatment for colorectal neoplastic lesions.


METHODS
From September 1999 to May 2003, 11 447 consecutive colonoscopic examinations in 9864 patients were gathered; totaling 5502 endoscopic treatments for colorectal neoplasms. Macroscopic characteristics of the neoplasms were classified into protruded (n = 3 953), sessile (n = 1402), lateral spreading tumor (n = 139) and depressed lesions (n = 8). Snare polypectomy was conducted in 3984 lesions, hot forcep removal in 1368 lesions, and endoscopic mucosal resection in 150 lesions.


RESULTS
Histological diagnoses were 4596 neoplastic lesions (4 376 adenomas and 220 adenocarcinomas) and 906 non-neoplastic lesions (891 hyperplastic and 15 inflammatory polyps). For the adenocarcinoma group, 31 instances involved submucosal invasion or resection margin, who received further operations, while 13 surgical specimens discovered no residual tumors. Three perforations and 96 bleedings were found following endoscopic treatment. No procedure-related mortality was found and no recurrent malignancy was found after 14-56 mo follow-up.


CONCLUSIONS
To lower the incidence and mortality of colorectal cancer, endoscopic treatment for colorectal neoplasms is a simple and safe procedure.
Su
Ming-Yao
MY
Department of Gastroenterology, Chang-Gung Memorial Hospital, Linkou Medical Center, 5 Fushin Street, Kweishan, Taoyuan, Taiwan, China.
Ho
Yu-Pin
YP
Hsu
Chen-Ming
CM
Chiu
Cheng-Tang
CT
Chen
Pang-Chi
PC
Lien
Jau-Min
JM
Tung
Shui-Yi
SY
Wu
Cheng-Shyong
CS
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003113:Colonoscopy / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies