Endoscopy 2003; 35(10): 845-849
DOI: 10.1055/s-2003-42622
Original Article
© Georg Thieme Verlag Stuttgart · New York

Long-Term Follow-Up of Large Flat Colorectal Tumors Resected Endoscopically

S.  Higaki 1 , S.  Hashimoto 1 , K.  Harada 1 , H.  Nohara 1 , Y.  Saito 1 , T.  Gondo 2 , K.  Okita 1
  • 1Department of Gastroenterology and Hepatology, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan
  • 2Department of Pathology, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan
Further Information

Publication History

Submitted 29 January 2003

Accepted after Revision 21 May 2003

Publication Date:
10 October 2003 (online)

Background and Study Aim: When a large flat colorectal tumor is excised by piecemeal endoscopic resection, it is not possible to obtain suitable specimens for histopathological examination to assess whether the resection has been complete. We prospectively analysed follow-up colonoscopy examinations of endoscopic polypectomy resection sites for residual lesions.
Patients and Methods: A total of 24 patients with large flat colorectal tumors were treated using an endoscopic submucosal saline injection technique. The resection site was prospectively examined for residual lesions using a magnifying colonoscope, at 3, 6, 12 and 24 months postoperatively.
Results: None of the 5 patients who underwent en bloc resection exhibited residual lesions postoperatively. Of the 19 patients who underwent piecemeal resection, one died of an asthma attack and 18 were followed up. Residual lesions were detected in four of these 18 patients (three adenomas and one cancer), which were resected endoscopically. When the tumor was resected endoscopically en bloc and was judged histologically to be completely resected, residual lesions were not detected at follow-up. However, residual lesions were detected in 22.2 % of patients 3 months after initial resection when polyps were resected piecemeal. After treatment, residual lesions were detected in two patients (11.1 %) at 24 months.
Conclusion: After piecemeal endoscopic resection for large flat colorectal tumors, it is necessary to follow-up and remove residual lesions endoscopically every 3 months until they all are removed.

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S. Higaki, M.D.

Department of Gastroenterology and Hepatology · Yamaguchi University School of Medicine ·

1-1-1 Minami Kogushi · Ube · Yamaguchi 755-8505 · Japan

Fax: +81-836-22-2240 ·

Email: higaki@mx51.tiki.ne.jp