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At least 1,603 records · Page 89Linked to original sources
PubMed2006

Endoloop-assisted polypectomy for large pedunculated colorectal polyps.

BACKGROUND: The use of an endoloop may minimize the risk for bleeding after endoscopic polypectomy of large colorectal polyps. This study aimed to assess the safety and efficacy of colonoscopic ligation of the stalk of large pedunculated polyps by means of an endoloop technique, and to focus particular attention on the instances in which the use of this device was unsuccessful. METHODS: This study retrospectively evaluated attempted endoloop endoscopic polypectomy in 33 patients (19 men and 14 women; mean age, 62.5 years) with large pedunculated polyps. RESULTS: Application of the endoloop was impossible in four patients, and the snare became entangled with the loop in one patient. The remaining 28 patients underwent endoloop-assisted polypectomy. Bleeding occurred in four patients, either because the loop slipped of the stalk after polypectomy (2 patients) or because a thin stalk (< or = 4 mm) was transected by the loop before polypectomy (2 patients). CONCLUSION: Colonoscopic polypectomy with an endoloop may be safer than conventional polypectomy. The reasons for technical failure of this technique include a narrow left colon lumen, a thin stalk (< or = 4 mm), and close cutting in relation to the site of encirclement by the loop.

Adult↗
PubMedDate not supplied

Follow-up of hot biopsy forceps treatment of diminutive colonic polyps.

Although the hot biopsy technique is widely used to treat diminutive colon polyps, there is concern over its efficacy and safety. Our study involved 39 patients undergoing routine colonoscopy in whom 62 diminutive polyps were found in the rectosigmoid. These lesions were treated with hot biopsy forceps in the standard manner. Flexible sigmoidoscopy was repeated 1 and 2 weeks later with the original treatment sites being identified. Eleven of the 62 sites (17%) revealed persistent viable polyp remnants, indicating incomplete treatment. In terms of safety, there were no clinical complications in this small study and most post-biopsy ulcers were healed by 2 weeks. This study shows that the hot biopsy technique may be unreliable in eradicating diminutive colon polyps.

Biopsy↗
PubMed2002

Virtual colonoscopy for the detection of colorectal polyps and cancers in a Chinese population.

AIM: The aim of this study is to assess the sensitivity of virtual colonoscopy in detecting colorectal polyps and cancers in a Chinese population. METHODS: Seventy-one consecutive Chinese patients (38 men and 33 women) referred for diagnostic colonoscopy were recruited. Patients received a routine bowel preparation in the morning followed by a helical abdominal computed tomography (CT) scan with air insufflation of the colon. The CT images were then processed by using surface-rendered software and interpreted by a single radiologist who was blinded to the clinical information. Colonoscopy was performed in the same afternoon without knowledge of the radiology results. All polyps and cancers were proven histologically. RESULTS: Five colorectal cancers were diagnosed and all were detected by virtual colonoscopy. The sensitivity and specificity of virtual colonoscopy for the detection of patients with polyps of all sizes, and patients with polyps >/=10 mm were 59, 92, 88 and 100%, respectively. The procedure was well tolerated by all patients. CONCLUSIONS: This study was carried out in a real clinical setting without a preselection of cases. Virtual colonoscopy was satisfactory for the detection of polyps greater than 10 mm, and for the diagnosis of cancer, and it is also a promising imaging modality for colorectal neoplasm detection in a Chinese population.

Colonic Polyps↗
PubMedDate not supplied

Colorectal lesions: evaluation with CT colography.

Computed tomographic (CT) colography is a promising technique for differentiating malignant or premalignant colorectal disease from benign lesions. In this technique, helical CT data are used to produce reformated two-dimensional (2D) CT images and simulated endoscopic images of the colon. Adenomatous polyps 0.7 cm in diameter or larger are easily detected on CT colographic images: A pedunculated polyp is identified by means of its stalk, whereas a sessile polyp appears as a polypoid soft-tissue mass projecting into the air-filled lumen of the colon. However, flat adenomas (lesions raised less than 2 mm from the surface of the colon) are difficult to detect with CT colography. In cases of colorectal cancer, both intraluminal and extraluminal disease can be evaluated with CT colography. Although CT colography does not allow differentiation between hyperplastic and adenomatous polyps, lipomas can be confidently diagnosed because of their fatty attenuation on reformatted 2D images. Pseudolesions that can produce false-positive findings at CT colography include the ileocecal valve, retained stool, retained barium, respiratory artifacts, and a stool-filled diverticulum.

Adenomatous Polyps↗
PubMed2000

Comparison of time-efficient CT colonography with two- and three-dimensional colonic evaluation for detecting colorectal polyps.

OBJECTIVE: We compared the findings of time-efficient CT colonography with complete two-dimensional (2D) and three-dimensional (3D) CT colonography and conventional colonoscopy in detecting colorectal polyps. SUBJECTS AND METHODS: Forty-two patients undergoing colonoscopy screening were examined with CT colonography before endoscopy. Data were examined following one of two methods. In method 1, axial 2D data sets were examined in a cine mode. If findings were suggestive of abnormality, focal areas were examined with 3D CT colonography. In method 2, data sets were examined exactly as in method 1, and subsequent to that review, data sets were examined with simultaneous 3D "fly-through" CT colonography (surface-rendered images) and multiplanar reformatted images. The time required to examine CT colonography using each technique was recorded and abnormal findings were documented. Results of methods 1 and 2 were compared with findings on colonoscopy. RESULTS: Colonoscopy detected 16 polyps in 13 patients (polyp size, 2-10 mm). Ten polyps measured 5 mm or less, five measured between 6 and 9 mm, and one measured 10 mm or more. Using method 1, two of 10 polyps measuring less than 5 mm, three of five polyps measuring between 6 and 9 mm, and one polyp measuring 10 mm were detected. We noted no false-positive polyps. Average evaluation time was 16 min. With method 2, the same polyps were seen as with method 1. No additional polyps were detected, and the average evaluation time was 40 min. CONCLUSION: Axial 2D CT colonography can be performed quickly and is comparable with complete 2D and 3D CT colonography in detecting colorectal polyps.

Aged↗
PubMed1975

Histology of polypoid lesions found in specimens resected for adenocarcinoma of the colon.

In a revision of 298 colectomy specimens resected for adenocarcinoma of the large bowell, 35 cases (13%) were found to have associated polypoid lesions. Twenty-nine of the polypoid lesions were adenomatous polyps, one a villous adenoma and other a retention polyp. Eight of the adenomatous polyps had a variable degree of benign atypical changes and malignant transformation occurred in four adenomatous polyps with the development of an adenocarcinoma. Four other lesions were small polypoid adenocarcinomas arising in normal colonic mucosa. Four double primary carcinomas were found among the 35 colectomy specimens with polyps. In this paper a significative incidence of malignant polypoid lesions associated with adenocarcinomas of the large bowell were found. The importance of well defined histological criteria in the diagnosis of malignancy and atypical changesin adenomatous polyps in stressed out.

Adenocarcinoma↗
PubMed1975

Significance of precancerous lesions in the colon and rectum.

The turnover of the colonic mucosa sheds some light on the understanding of the precancerous stages. The colon mucosa operates through a constant and regular epithelial renewal. The regularity of this cycle is controlled by two membranous systems: the basement membrane as a sliding support- coat and the as a brake in the cells progression and thus in the mitosis. Any disturbance, in these system, brings about a large extension of the proliferative area, according to modalities common to all varieties of precancerous, polypous or non-polypous condition. On this poll of undifferentiated cells, with frequent mitosis risks of cancerous changes are, all the higher, that the undifferentiated areas or growing areas are more extended. This explains the unequal tendency to malignancy of colitis, solitary polyps, villous polyps in layers, and multiple polyps.

Animals↗
PubMed1989

Gastrointestinal polyposis syndromes.

Well recognized cutaneointestinal syndromes in which colonic polyps are a constant and defining feature include Gardner's syndrome (familial adenomatous polyposis), Peutz-Jeghers syndrome, and Cronkhite-Canada syndrome. Colonic polyps are also found with increased frequency in Cowden's disease, the Muir-Torre syndrome, and neurofibromatosis. The Ruvalcaba-Myhre-Smith syndrome is a newly defined entity in this category. The relationship between acrochordons and colonic polyps remains a controversial issue, awaiting additional studies.

Humans↗
PubMed1995

Small colorectal polyps: histopathology and clinical significance.

OBJECTIVES: The development of colorectal adenomas and carcinoma involves both environmental and genetic factors. Wide variations among populations have been observed in the prevalence of adenoma. Investigations of the small colorectal polyps have been divergent. The distribution of these small polyps remains in controversy. The histology, clinical significance, and optimal treatment of such lesions have yet to be defined. The aim of the present prospective study is to ascertain the importance of small colorectal polyps in the Taiwanese and to define their histopathological nature, spatial distribution, and clinical significance. METHODS: We prospectively evaluated all patients referred for colonoscopy for miscellaneous indications. All raised lesions encountered during the procedure were removed or biopsied. Each polyp was estimated in situ by visual comparison with the known width of a standard fully opened biopsy forceps. Small colorectal polyps were defined as those measuring 8 mm or less in diameter. Histopathology of these small polyps were reviewed and correlated clinically. RESULTS: 124 patients were found to have 159 small colorectal polyps. There were 88 men (71%) and 36 women (29%). The mean ages were 60.2 yr for men and 50.8 yr for women. Solitary polyps were present in 68.5% of patients while 26.6% had two polyps and 4.9% had between 3 and 10 polyps; 60.4% of the small polyps were neoplastic, while 39.6% including 23.9% hyperplastic polyps were nonneoplastic; 50.3% of the small polyps were located in the rectosigmoid. Tubular adenomas accounted for 90.6% of the small neoplastic polyps. The neoplastic polyps predominated in each colorectal segment. The proportion of small neoplastic polyps was higher in older patients; 2.8% of the small adenomas showed moderate dysplasia. Severe dysplasia was noted in only one polyp. No malignancy was observed. The chi-square test with Yates' correction was used for statistical analysis. CONCLUSIONS: These findings reveal that a large share of the small colorectal polyps are neoplastic and therefore at risk to progress to carcinoma. The location of small polyps distributed at the rectosigmoid or the proximal colon was of no significance (p > 0.2) for the proportion of neoplastic polyps. The older patients probably have higher risk because of their higher proportions of small neoplastic polyps. All polyps should be removed when encountered during colonoscopy due to the high prevalence of adenomas among small colorectal polyps.

Adult↗