Small Colorectal Polyps

被引：7

作者：

Schoefl, Rainer ^{[1
]}

Ziachehabi, Alexander ^{[1
]}

Wewalka, Friedrich ^{[1
]}

机构：

[1] Krankenhaus Elisabethinen Linz, Dept Gastroenterol Hepatol Metab Nutr & Endocrino, AT-4020 Linz, Austria

来源：

DIGESTIVE DISEASES | 2015年 / 33卷 / 01期

关键词：

Colorectal polyps; Characterisation; Resection; Discard; BIOPSY FORCEPS; COLONOSCOPY; CLASSIFICATION; POLYPECTOMY; DIAGNOSIS; ADENOMAS; SAFETY; SIZE;

D O I：

10.1159/000366034

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Small (<10 mm) and diminutive (<6 mm) polyps harbour high-grade dysplasia or cancer in 0.3-5% of cases. The potential to grow and develop advanced histology is low. Traditional guidelines still recommend the removal of all polyps. Visual characterisation with modern endoscopic technology could enable us to leave diminutive hyperplastic polyps in situ and remove but discard small polyps. In expert hands, high-definition white-light endoscopy and virtual chromoendoscopy can reach an accuracy of more than 90% in distinguishing between hyperplastic and adenomatous pathology. For less experienced endoscopists the values are lower and therefore the concept is not yet fit for routine use. Polyps can be removed completely with snares but not with forceps. The cold snaring technique in particular has proved safe and effective for small polyps. With more experience in the future a 'cut and discard' strategy for small polyps and a 'do not resect' strategy for diminutive polyps will save money and time to deal with more advanced lesions. (C) 2014 S. Karger AG, Basel

引用

页码：38 / 41

页数：4

共 19 条

[1] Biopsy forceps is inadequate for the resection of diminutive polyps [J].

Efthymiou, M. ;

Taylor, A. C. F. ;

Desmond, P. V. ;

Allen, P. B. ;

Chen, R. Y. .

ENDOSCOPY, 2011, 43 (04) :312-316

[2] High-grade dysplasia and invasive carcinoma in colorectal adenomas:: a multivariate analysis of the impact of adenoma and patient characteristics [J].

Gschwantler, M ;

Kriwanek, S ;

Langner, E ;

Göritzer, B ;

Schrutka-Kölbl, C ;

Brownstone, E ;

Feichtinger, H ;

Weiss, W .

EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 2002, 14 (02) :183-188

[3] Prevalence of advanced histological features in diminutive and small colon polyps [J].

Gupta, Neil ;

Bansal, Ajay ;

Rao, Deepthi ;

Early, Dayna S. ;

Jonnalagadda, Sreenivasa ;

Wani, Sachin B. ;

Edmundowicz, Steven A. ;

Sharma, Prateek ;

Rastogi, Amit .

GASTROINTESTINAL ENDOSCOPY, 2012, 75 (05) :1022-1030

[4] Delaunay triangulation-based pit density estimation for the classification of polyps in high-magnification chromo-colonoscopy [J].

Haefner, M. ;

Liedlgruber, M. ;

Uhl, A. ;

Vecsei, A. ;

Wrba, F. .

COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE, 2012, 107 (03) :565-581

[5] Systematic review: distribution of advanced neoplasia according to polyp size at screening colonoscopy [J].

Hassan, C. ;

Pickhardt, P. J. ;

Kim, D. H. ;

Di Giulio, E. ;

Zullo, A. ;

Laghi, A. ;

Repici, A. ;

Iafrate, F. ;

Osborn, J. ;

Annibale, B. .

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2010, 31 (02) :210-217

[6] A Resect and Discard Strategy Would Improve Cost-Effectiveness of Colorectal Cancer Screening [J].

Hassan, Cesare ;

Pickhardt, Perry J. ;

Rex, Douglas K. .

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2010, 8 (10) :865-869

[7] Validation of a Simple Classification System for Endoscopic Diagnosis of Small Colorectal Polyps Using Narrow-Band Imaging [J].

Hewett, David G. ;

Kaltenbach, Tonya ;

Sano, Yasushi ;

Tanaka, Shinji ;

Saunders, Brian P. ;

Ponchon, Thierry ;

Soetikno, Roy ;

Rex, Douglas K. .

GASTROENTEROLOGY, 2012, 143 (03) :599-U79

[8] Leaving distal colorectal hyperplastic polyps in place can be achieved with high accuracy by using narrow-band imaging: an observational study [J].

Hewett, David G. ;

Huffman, Melanie E. ;

Rex, Douglas K. .

GASTROINTESTINAL ENDOSCOPY, 2012, 76 (02) :374-380

[9] NATURAL HISTORY OF SMALL COLORECTAL PROTUBERANT ADENOMAS [J].

Hisabe, Takashi ;

Tsuda, Sumio ;

Matsui, Toshiyuki ;

Iwashita, Akinori .

DIGESTIVE ENDOSCOPY, 2010, 22 :S43-S46

[10] Growth of colorectal polyps: Redetection and evaluation of unresected polyps for a period of three years [J].

Hofstad, B ;

Vatn, MH ;

Andersen, SN ;

Huitfeldt, HS ;

Rognum, T ;

Larsen, S ;

Osnes, M .

GUT, 1996, 39 (03) :449-456

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