EXPERIENCE OF COLONOSCOPIC POLYPECTOMY WITH SPECIAL REFERENCE TO ITS VALUE AS EXCISION BIOPSY AND TREATMENT OF COLORECTAL POLYPS

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Three hundred and seventy polyps in one hundred and ninety four patients were removed via colonoscope between 1972 and 1978, and histologically examined. Eighty percent of the removed polyps were neoplastic and malignant transformation in adenoma was found in 19.6%. The malignancy rate increased with increasing size of the polyp, however it was interesting to note that malignancy rate of adenoma under 1 cm in diameter was as high as 7.3%. In all 49 early carcinomas but two, found in this polypectomy series, showed histological evidence of adenoma origin. Early carcinoma 1-2 cm in diameter or semipedunculated in shape was the commonest type. Management of sessile adenoma and invasive carcinoma was discussed and our experience was also presented.Long-term follow-up of patients with adenoma was recommended in terms of detecting second neoplastic lesions as early as possible. The value of colonoscopic polypectomy as excision biopsy and treatment of colonic polyps was stressed. From histological investigation of the removed polyps it was expected to find a new concept of pathogenesis of colorectal carcinoma.
財団法人日本消化器病学会の論文