Prevalence, histology, endoscopic treatment and long-term follow-up of large colonic polyps and laterally spreading tumors. The Romanian experience.
OBJECTIVE
We report the prevalence, histological aspect, endoscopic treatment and follow-up of colonic polyps of 2 cm or larger and of laterally spreading tumors (LSTs) in an eastern European country.


METHODS
All consecutive colonoscopies carried out over a 1-year period (3,856) in the Endoscopy Department of the 3rd Medical Clinic Cluj-Napoca were evaluated. Fifty-two polyps and 12 LSTs of >=2cm diameter were found. Size, location and histological aspect of large colonic polyps and LSTs were assessed. Endoscopic or surgical resection was recorded. An extensive endoscopic and histological follow-up was performed.


RESULTS
Median size of polyps was 32mm and of LSTs 41mm. Invasive carcinoma was found in 7 polyps (20.6%) and in 4 LSTs (28.6%). Thirty-six polyps were endoscopically resected (69.2%). A complete endoscopic excision was performed in 35 polyps (98.6%). Histological complete resection was achieved in 30 polyps (83.3%). Thirteen polyps were surgically resected (25%). Eight LSTs were endoscopically resected (64.3%) using endoscopic piecemeal resection (EPMR). A complete endoscopic excision was performed in three LSTs (37.5%). Three LSTs were surgically resected (21.5%). In the polyp group, one patient presented endoscopic recurrence (16.6%) at 6 months follow-up. In the LST group, two invasive recurrences were present at 3 and 30 months of follow-up.


CONCLUSIONS
A complete resection can be performed in the majority of large polyps. LSTs larger than 50mm, incomplete resection and superficial invasive carcinoma were correlated with endoscopic recurrence. EPMR might be a curative method for LSTs but an accurate endoscopic diagnosis and long-term endoscopic follow-up are mandatory.
Tantau
Alina I
AI
4th Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, Str. Gh. Bilascu 16-20, Cluj-Napoca, Romania. alina_onica2002@yahoo.com
Tantau
Marcel V
MV
Serban
Alexandru
A
Zaharie
Teodor
T
Cruciat
Carmen
C
Badea
Radu
R
Pascu
Oliviu
O
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D003106:Colon / Q000473:pathology / Q000601:surgery; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D003111:Colonic Polyps / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015995:Prevalence; D012008:Recurrence; D012383:Romania / Q000453:epidemiology; D016896:Treatment Outcome