Elective colectomy after colonoscopic polypectomy for unexpected polypoid T1 cancer
Fuente:
Redalyc
Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Artículo científico |
| Sprache: | en |
| Veröffentlicht: |
Vilniaus Universitetas
2015
|
| Schlagworte: | |
| Online-Zugang: | |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| _version_ | 1876474912120504320 |
|---|---|
| author | Nikas Samuolis |
| author_facet | Nikas Samuolis |
| contents | Elective colectomy after colonoscopic polypectomy for unexpected polypoid T1 cancer Nikas Samuolis Narimantas Evaldas Samalavičius Ugnius Mickys Medicina lymph node metastasis endoscopic polypectomy Malignant colonic polyp Purpose. The treatment of early-stage colorectal adenocarcinoma removed endoscopically depends on histopathologic findings. The aim of this retrospective study was to assess the benefit–risk balance to patients who underwent colectomy after endoscopic polypectomy of T1 carcinoma with unfavourable histological factors. Methods. Thirty one patients (15 men and 16 women, median age 66 years) who underwent colectomy after endoscopic resection of malignant polyps with T1 carcinoma within the period from 1 January 2004 to 11 February 2015 were included in this retrospective study. Specimens resected after endoscopic polypectomy showed at least one of the following unfavourable factors: no free margin or piecemeal resection. The main objective was to assess the benefit–risk balance of an oncological resection performed after the polypectomy. The oncological benefit was measured by the lymph node metastasis rate. The risk was measured by the occurrence of severe complications of grade III–IV or death. Results. The most common localisation of T1 cancer was sigmoid colon – 16 cases (51.6%) and upper rectum – 11 cases (35.5%). 11 (35.5%) patients had well-differentiated adenocarcinoma (G1), others (20 patients from 31, 64.5%) had moderate differentiated adenocarcinoma (G2). The main indications of colectomy were two: the margin of resection ≤1 mm (n = 23) and piecemeal resection (n = 9). An oncological benefit of colectomy was reached for four patients (12.9%), who had lymph node metastasis. Six patients (19.4%) presented postoperative complications. All of them were of I–II grade according to the Clavien classification. There were no deaths. Conclusions. 12.9% of patients, who underwent oncological colectomy after endoscopic polypectomy for unexpected polypoid T1 cancer with unfavourable histology (no free margin or piecemeal polypectomy), had metastasis in the lymph nodes; thus this study suggests the rationale of an oncological surgical resection after endoscopic polypectomy for these patients. 2015 artículo científico 2029-4174 https://www.redalyc.org/articulo.oa?id=694074035003 en http://www.redalyc.org/revista.oa?id=6940 Acta medica Lituanica application/pdf Vilniaus Universitetas Acta medica Lituanica (Lituania) Num.1 Vol.22 |
| format | Artículo científico |
| id | redalyc_694074035003 |
| institution | Redalyc |
| language | en |
| publishDate | 2015 |
| publisher | Vilniaus Universitetas |
| spellingShingle | Elective colectomy after colonoscopic polypectomy for unexpected polypoid T1 cancer Nikas Samuolis Medicina lymph node metastasis endoscopic polypectomy Malignant colonic polyp Elective colectomy after colonoscopic polypectomy for unexpected polypoid T1 cancer Nikas Samuolis Narimantas Evaldas Samalavičius Ugnius Mickys Medicina lymph node metastasis endoscopic polypectomy Malignant colonic polyp Purpose. The treatment of early-stage colorectal adenocarcinoma removed endoscopically depends on histopathologic findings. The aim of this retrospective study was to assess the benefit–risk balance to patients who underwent colectomy after endoscopic polypectomy of T1 carcinoma with unfavourable histological factors. Methods. Thirty one patients (15 men and 16 women, median age 66 years) who underwent colectomy after endoscopic resection of malignant polyps with T1 carcinoma within the period from 1 January 2004 to 11 February 2015 were included in this retrospective study. Specimens resected after endoscopic polypectomy showed at least one of the following unfavourable factors: no free margin or piecemeal resection. The main objective was to assess the benefit–risk balance of an oncological resection performed after the polypectomy. The oncological benefit was measured by the lymph node metastasis rate. The risk was measured by the occurrence of severe complications of grade III–IV or death. Results. The most common localisation of T1 cancer was sigmoid colon – 16 cases (51.6%) and upper rectum – 11 cases (35.5%). 11 (35.5%) patients had well-differentiated adenocarcinoma (G1), others (20 patients from 31, 64.5%) had moderate differentiated adenocarcinoma (G2). The main indications of colectomy were two: the margin of resection ≤1 mm (n = 23) and piecemeal resection (n = 9). An oncological benefit of colectomy was reached for four patients (12.9%), who had lymph node metastasis. Six patients (19.4%) presented postoperative complications. All of them were of I–II grade according to the Clavien classification. There were no deaths. Conclusions. 12.9% of patients, who underwent oncological colectomy after endoscopic polypectomy for unexpected polypoid T1 cancer with unfavourable histology (no free margin or piecemeal polypectomy), had metastasis in the lymph nodes; thus this study suggests the rationale of an oncological surgical resection after endoscopic polypectomy for these patients. 2015 artículo científico 2029-4174 https://www.redalyc.org/articulo.oa?id=694074035003 en http://www.redalyc.org/revista.oa?id=6940 Acta medica Lituanica application/pdf Vilniaus Universitetas Acta medica Lituanica (Lituania) Num.1 Vol.22 |
| title | Elective colectomy after colonoscopic polypectomy for unexpected polypoid T1 cancer |
| topic | Medicina lymph node metastasis endoscopic polypectomy Malignant colonic polyp |
| url | https://www.redalyc.org/articulo.oa?id=694074035003 |