Prognosis after endoscopic polypectomy for colorectal polyps.

概要

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During the past fifteen years 1, 085 colorectal polys in 597 cases have been removed by colonoscopic polypectomy. In this study, the prognosis after colonoscopic polypectomy was analyzed. Five cases of complication accounted for 0.8 %. There was no death in this series. Sixty-five patients (11 %) had early carcinoma, 52 being intramucosal and the remaining 13 submucosal carcinomas. Eleven of these cases were given additional surgical treatment because of massive submucosal invasion, a positive polypectomised surgical margin or positive lymphatic invasion. Follow-up study of these patients showed that four died of other forms of carcinoma, two died of other diseases, one died of associated synchronous invasive colonic carcinoma and the remaining 56 cases were alive, the longest survival being twelve years, with the exception of two drop-out cases. Only in one case of intramucosal carcinoma, invasive carcinoma developed at the polypectomised site after 28 months. Of these patients 29 % had synchronous or metachronous invasive carcinomas and 56 % had more than one adenoma. It seemed that these background factors were important ones affecting the prognosis of early carcinomas removed endoscopically. Eighty-eight patients after colorectal polypectomy were followed up with colonoscopy. The rate of missing a significant-sided polyp was 12.5 %. Patients with more than two adenomas had an increased risk of recurrence.