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| Format: | Artículo científico |
| Language: | en |
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Sociedad Argentina de Gastroenterología
2016
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| Online Access: | https://www.redalyc.org/articulo.oa?id=199347749003 |
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Table of Contents:
- Prevalence and clinicopathologic features of colorectal laterally spreading tumors in Brazil Carlos Eduardo Oliveira dos Santos Júlio Carlos Pereira-Lima Daniele Malaman Tiago dos Santos Carvalho Michele Lemos Bonotto Medicina LST piecemeal technique Colorectal laterally spreading tumors This study aims to assess the prevalence and clinicopathologic features of colorectal laterally spreading tumors (LSTs). Methods. Among 2067 superficial neoplastic lesions diagnosed in 1135 consecutive patients, we evaluated 91 patients with 96 LSTs classified as granular (homogeneous and nodular mixed) and non-granular (flat elevated and pseudodepressed) types. Lesions were evaluated according to their clinicopathologic features. LSTs ≤ 20 mm were resected en bloc and LSTs > 20 mm by piecemeal resection. Recurrence was analyzed. Results. Overall prevalence of LSTs was 2.5% among all colonoscopies, accounting for 4.6% of superficial neoplastic lesions. Of 96 LSTs, 68 (70.8%) were granular (42 homogeneous and 26 nodular mixed). Among non-granular LSTs, 21 were flat elevated and 7 were pseudodepressed. Granular LSTs of the nodular mixed subtype were significantly larger than those of the homogeneous subtype (p < 0.01), with no difference in size between non-granular subtypes. Twenty-three (24%) LSTs had advanced histology. Logistic regression analysis showed that lesion size > 20 mm (OR: 12.2; IC 95%: 3.8-39.2) and pseudo-depressed (OR: 8.0; IC 95%: 1.2-55.3) and especially nodular mixed (OR: 23.3; IC 95%: 4.6-117.4) subtypes were risk factors for advanced histology. All patients underwent endoscopic mucosal resection, which was complemented with surgical intervention in one case. Recurrence occurred in 6.4% (5/78) of cases and was associated with lesions > 20 mm removed by piecemeal resection (p = 0.003) and with advanced histology (p = 0.009). Conclusions. LST accounted for 4.6% of superficial neoplastic lesions and 10% of non-polypoid neoplasms. Those lesions > 20 mm pseudo-depressed and nodular mixed subtypes were considered risk factors for advanced histology. Endoscopic mucosal resection, even using the piecemeal technique, is still a fair option for the treatment of LSTs. 2016 artículo científico 2469-1119 https://www.redalyc.org/articulo.oa?id=199347749003 en http://www.redalyc.org/revista.oa?id=1993 Acta Gastroenterológica Latinoamericana application/pdf Sociedad Argentina de Gastroenterología Acta Gastroenterológica Latinoamericana (Argentina) Num.3 Vol.46