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KMID : 0378020070500110045
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New Medical Journal
2007 Volume.50 No. 11 p.45 ~ p.49
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Features and Endoscopic Treatment of Colorectal Lateral Spreading Tumor: Single Center Experience
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Jeong Jeong-Jo
Oh Jung-Hwan
Jeon Eun-Jung
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Abstract
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Background and Aims Laterally spreading tumors (LST) of the colon are best removed by endoscopic mucosal resection (EMR) as they extend laterally rather than vertically. Since they sometimes invade deeply into the submucosal layer, it is important to assess the depth of invasion endoscopically before treatment. In the present study, we analysed retrospectively the LSTs treated by EMR in our hospital.
Material and Methods : 30 LSTs endoscopically removed at the St. Paul Hospital, Seoul, between March 2003 and August 2008 were retrospectively analyzed. These lesions were classificated macroscopic (granular type and nongranular type) and microscopic findings.
Results: 30 LSTs were treated by endoscopic mucosal resecton. 16 LSTs (53.3%) were less than 20 mm in diameter, 11 (36.7%) were 20~30 mm, 3 (10.0%) were larger than 30 mm. The most frequent location was ascending colon (11/33, 36.7%), followed by rectum (10/33, 33.3%). Morphplogic types were GH types 33.3% (10/30), MN types 16.7% (5/46) and NG types 50.0% (15/30). En bloc resection was successful in 11 of 30 lesions (36.7%); in the remaining lesions, piecemeal resection was done (63.3%, 19/30). Histologic types were tubular adenomas 70.0% (21/30), tubulovillous adenomas 20.0% (6/30), hyperplastic polyp 3.3% (1/30), serrated adenoma 33% (1/30) and carcinoma in situ 3.3% (1/30). One remnant lesion after EMR was completely treated by EMR and APC. One patient experi-enced delayed bleeding after EMR that was succefullu treated by endoscopic clipping. No perforation developed following EMR.
Conclusion: EMR for colorectal LSTs is a safe and effective treatment despite their large size because of the low risk of invasive adenocarcinoma.
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KEYWORD
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Laterally spreading tumor, Endoscopic mucosal resection
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