Large colorectal polyps

Endoscopic management and rate of malignancy: Does size matter?

Sushil K. Ahlawat, Naveen Gupta, Stanley B. Benjamin, Firas Al Kawas

Research output: Contribution to journalArticle

Abstract

Background And Study Aims: High rate of malignancy has been reported in large colorectal polyps. However, studies were limited by including surgically resected polypoid lesions, only polyp ≥3 cm, only sessile polyps or carcinoma in situ. The aim of the study was to define the prevalence of invasive carcinoma among colorectal polyps ≥2 cm in diameter detected by colonoscopy and also to study the success of endoscopic resection. Patients And Methods: All polypectomies of ≥2 cm colorectal polyps were identified from our endoscopy and pathology database and patients' medical records were reviewed for gross features, techniques of resection, complications, histology, and follow-up. Standard statistical tests were applied for calculating the rates, prevalence, and difference in proportions. Results: Colonoscopic resection of 183 large polyps was performed in 174 patients over a period of 6 years (55% men and 45% women), mean age 64 years (median 67 y and range 25-91 y). The majority of polyps were sessile (84%). Fifty-six percent were located in the right colon. Invasive cancer was found in 10% of polyps. Endoscopic resection was successful in 89% of patients. Postpolypectomy bleeding and perforation was noted in 5% and 2% of patients, respectively. No death was observed. Seventy-eight percent of patients completed >1 year of follow-up after initial polypectomy. Recurrence of adenoma was noted in 12%, which was managed successfully by colonoscopic polypectomy techniques. Conclusions: The rate of invasive cancer is low among endoscopically resected large colorectal polyps and most of these polyps can be resected successfully via colonoscopy with minimal morbidity and no mortality. A close endoscopic follow-up is required to monitor for recurrence.

Original languageEnglish (US)
Pages (from-to)347-354
Number of pages8
JournalJournal of Clinical Gastroenterology
Volume45
Issue number4
DOIs
StatePublished - 2011
Externally publishedYes

Fingerprint

Polyps
Neoplasms
Colonoscopy
Recurrence
Carcinoma in Situ
Adenoma
Endoscopy
Medical Records
Colorectal Neoplasms
Histology
Colon
Databases
Pathology
Hemorrhage
Morbidity
Mortality

Keywords

  • colon adenoma
  • colon polyp
  • colonoscopy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Large colorectal polyps : Endoscopic management and rate of malignancy: Does size matter? / Ahlawat, Sushil K.; Gupta, Naveen; Benjamin, Stanley B.; Al Kawas, Firas.

In: Journal of Clinical Gastroenterology, Vol. 45, No. 4, 2011, p. 347-354.

Research output: Contribution to journalArticle

Ahlawat, Sushil K. ; Gupta, Naveen ; Benjamin, Stanley B. ; Al Kawas, Firas. / Large colorectal polyps : Endoscopic management and rate of malignancy: Does size matter?. In: Journal of Clinical Gastroenterology. 2011 ; Vol. 45, No. 4. pp. 347-354.
@article{14d067db57e9472ebe7a717443b37842,
title = "Large colorectal polyps: Endoscopic management and rate of malignancy: Does size matter?",
abstract = "Background And Study Aims: High rate of malignancy has been reported in large colorectal polyps. However, studies were limited by including surgically resected polypoid lesions, only polyp ≥3 cm, only sessile polyps or carcinoma in situ. The aim of the study was to define the prevalence of invasive carcinoma among colorectal polyps ≥2 cm in diameter detected by colonoscopy and also to study the success of endoscopic resection. Patients And Methods: All polypectomies of ≥2 cm colorectal polyps were identified from our endoscopy and pathology database and patients' medical records were reviewed for gross features, techniques of resection, complications, histology, and follow-up. Standard statistical tests were applied for calculating the rates, prevalence, and difference in proportions. Results: Colonoscopic resection of 183 large polyps was performed in 174 patients over a period of 6 years (55{\%} men and 45{\%} women), mean age 64 years (median 67 y and range 25-91 y). The majority of polyps were sessile (84{\%}). Fifty-six percent were located in the right colon. Invasive cancer was found in 10{\%} of polyps. Endoscopic resection was successful in 89{\%} of patients. Postpolypectomy bleeding and perforation was noted in 5{\%} and 2{\%} of patients, respectively. No death was observed. Seventy-eight percent of patients completed >1 year of follow-up after initial polypectomy. Recurrence of adenoma was noted in 12{\%}, which was managed successfully by colonoscopic polypectomy techniques. Conclusions: The rate of invasive cancer is low among endoscopically resected large colorectal polyps and most of these polyps can be resected successfully via colonoscopy with minimal morbidity and no mortality. A close endoscopic follow-up is required to monitor for recurrence.",
keywords = "colon adenoma, colon polyp, colonoscopy",
author = "Ahlawat, {Sushil K.} and Naveen Gupta and Benjamin, {Stanley B.} and {Al Kawas}, Firas",
year = "2011",
doi = "10.1097/MCG.0b013e3181f3a2e0",
language = "English (US)",
volume = "45",
pages = "347--354",
journal = "Journal of Clinical Gastroenterology",
issn = "0192-0790",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Large colorectal polyps

T2 - Endoscopic management and rate of malignancy: Does size matter?

AU - Ahlawat, Sushil K.

AU - Gupta, Naveen

AU - Benjamin, Stanley B.

AU - Al Kawas, Firas

PY - 2011

Y1 - 2011

N2 - Background And Study Aims: High rate of malignancy has been reported in large colorectal polyps. However, studies were limited by including surgically resected polypoid lesions, only polyp ≥3 cm, only sessile polyps or carcinoma in situ. The aim of the study was to define the prevalence of invasive carcinoma among colorectal polyps ≥2 cm in diameter detected by colonoscopy and also to study the success of endoscopic resection. Patients And Methods: All polypectomies of ≥2 cm colorectal polyps were identified from our endoscopy and pathology database and patients' medical records were reviewed for gross features, techniques of resection, complications, histology, and follow-up. Standard statistical tests were applied for calculating the rates, prevalence, and difference in proportions. Results: Colonoscopic resection of 183 large polyps was performed in 174 patients over a period of 6 years (55% men and 45% women), mean age 64 years (median 67 y and range 25-91 y). The majority of polyps were sessile (84%). Fifty-six percent were located in the right colon. Invasive cancer was found in 10% of polyps. Endoscopic resection was successful in 89% of patients. Postpolypectomy bleeding and perforation was noted in 5% and 2% of patients, respectively. No death was observed. Seventy-eight percent of patients completed >1 year of follow-up after initial polypectomy. Recurrence of adenoma was noted in 12%, which was managed successfully by colonoscopic polypectomy techniques. Conclusions: The rate of invasive cancer is low among endoscopically resected large colorectal polyps and most of these polyps can be resected successfully via colonoscopy with minimal morbidity and no mortality. A close endoscopic follow-up is required to monitor for recurrence.

AB - Background And Study Aims: High rate of malignancy has been reported in large colorectal polyps. However, studies were limited by including surgically resected polypoid lesions, only polyp ≥3 cm, only sessile polyps or carcinoma in situ. The aim of the study was to define the prevalence of invasive carcinoma among colorectal polyps ≥2 cm in diameter detected by colonoscopy and also to study the success of endoscopic resection. Patients And Methods: All polypectomies of ≥2 cm colorectal polyps were identified from our endoscopy and pathology database and patients' medical records were reviewed for gross features, techniques of resection, complications, histology, and follow-up. Standard statistical tests were applied for calculating the rates, prevalence, and difference in proportions. Results: Colonoscopic resection of 183 large polyps was performed in 174 patients over a period of 6 years (55% men and 45% women), mean age 64 years (median 67 y and range 25-91 y). The majority of polyps were sessile (84%). Fifty-six percent were located in the right colon. Invasive cancer was found in 10% of polyps. Endoscopic resection was successful in 89% of patients. Postpolypectomy bleeding and perforation was noted in 5% and 2% of patients, respectively. No death was observed. Seventy-eight percent of patients completed >1 year of follow-up after initial polypectomy. Recurrence of adenoma was noted in 12%, which was managed successfully by colonoscopic polypectomy techniques. Conclusions: The rate of invasive cancer is low among endoscopically resected large colorectal polyps and most of these polyps can be resected successfully via colonoscopy with minimal morbidity and no mortality. A close endoscopic follow-up is required to monitor for recurrence.

KW - colon adenoma

KW - colon polyp

KW - colonoscopy

UR - http://www.scopus.com/inward/record.url?scp=85027942416&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85027942416&partnerID=8YFLogxK

U2 - 10.1097/MCG.0b013e3181f3a2e0

DO - 10.1097/MCG.0b013e3181f3a2e0

M3 - Article

VL - 45

SP - 347

EP - 354

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

IS - 4

ER -