Endoscopic treatment of colorectal neoplasms: a simple and safe procedure to lower the incidence of colorectal cancers.
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 larger numbers of endoscopic diagnoses and treatments for colorectal neoplasms. The purpose of this investigation is to evaluate the efficacy and outcomes of endoscopic treatment for colorectal neoplastic lesions and the development of colorectal cancers after colonoscopic therapy.


METHODS
From September 1999 to May 2005, 19,815 consecutive colonoscopic examinations in 16,318 patients were gathered, totaling 9,534 endoscopic treatments for colorectal neoplasms. Macroscopic characteristics of the neoplasms were classified into protruded (N = 7,455), sessile (N = 1,569), lateral spreading tumor (N = 201), depressed lesions (N = 21), and flat lesions (N = 288). Snare polypectomy was conducted in 7,536 lesions, hot forceps removal in 1,545 lesions, and endoscopic mucosal resection in 353 lesions.


RESULTS
Histological diagnoses were 8,333 neoplastic lesions (8,246 adenomas with low/high-grade dysplasia and 87 invasive adenocarcinomas) and 1,201 non-neoplastic lesions (1,186 hyperplastic and 15 inflammatory polyps). For the adenocarcinoma group, all had received further operations, while 73 surgical specimens discovered no residual tumors. Four perforations and 146 bleedings were found following endoscopic treatment. No procedure-related mortality was found and no recurrent malignancy was found after 6-71 months follow-up.


CONCLUSIONS
To lower the incidence and mortality of advanced colorectal cancer, endoscopic treatment for colorectal neoplasms is a simple and safe procedure.
Su
Ming-Yao
MY
Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kweishan, Taoyuan, Taiwan.
Hsu
Chen-Ming
CM
Lin
Chun-Jung
CJ
Ho
Yu-Pin
YP
Chiu
Cheng-Tang
CT
Chen
Pang-Chi
PC
Lien
Jau-Min
JM
Wu
Cheng-Shyong
CS
Tung
Shui-Yi
SY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D016896:Treatment Outcome