Clinicopathological Study on Re-formation of Colorectal Adenomas after Polypectomy

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Clinicopathological study was made on 8 cases showing re-formed adenomas after polypectomy in the colon and rectum and also on 2 cases of metachronous adenomas. Re-formed adenomas were found during the period from 6 months to 2 years after polypectomy and two metachronous adenoma were found at 2 years and 4 months and 2 years and 6 months after polypectomy, respectively. The frequency of the re-formation was 0.97% (4 cases out of a total 414 cases, 622 adenomas) in colonoscopic polypectomy, and it was 2.8% (4 cases of a total 142 cases) in surgical local-resection. The histologic types of adenomatous polyps causing the re-formation were villous in 2 cases, villotubular in 3 cases, and tubular in 3 cases. All the 8 adenomas which caused the re-formation after polypectomy were large in size and sessile or semipedunculate in shape. All of them were histologically severe atypia and often contained tiny foci of cancer within adenoma. No small and/or pedunculate adenomas as well as adenomas of low grade atypia recurred after polypectomy. Cause of the adenoma re-formation after polypectomy was discussed and it was stressed that removal of the surrounding mucosa with adenomas was important to avoid re-formation, when the adenoma was large in size and the pedicle was short.
日本大腸肛門病学会の論文