High incidence of metachronous advanced adenoma and cancer after endoscopic resection of colon polyps %26gt;= 20mm in size

作者：Yoshida Naohisa; Naito Yuji; Siah Kewin Tien Ho; Murakami Takaaki; Ogiso Kiyoshi; Hirose Ryohei; Inada Yutaka; Inoue Ken; Konishi Hideyuki; Kugai Munehiro; Morimoto Yasutaka; Hasegawa Daisuke; Kanemasa Kazuyuki; Wakabayashi Naoki; Yagi Nobuaki; Yanagisawa Akio; Itoh Yoshito

来源：Digestive Endoscopy, 2016, 28(2): 194-202.

DOI：10.1111/den.12551

• colorectal polyp
• endoscopic mucosal resection (EMR)
• endoscopic submucosal dissection (ESD)
• metachronous lesion
• colorectal cancer

Background and AimThere are limited studies on incidence rates of metachronous neoplastic lesions after resecting large colorectal polyps. In the present study, we analyzed metachronous lesions after endoscopic resection of colorectal polyps 20mm in size.
MethodsWe retrospectively analyzed consecutive patients who underwent endoscopic resection of polyps from 2006 to 2013 at two affiliated hospitals. All patients underwent at least two total colonoscopies before follow up to ensure minimal missed polyps. Only patients who had follow-up colonoscopy annually after resection were recruited. We separated patients according to size of polyp resected; there were 239 patients in the 20-mm group and 330 patients in the <20-mm group. Clinical characteristics and cumulative rates of metachronous advanced adenoma and cancer in both groups were analyzed. Advanced adenoma was defined as a neoplastic lesion 10mm in size and adenoma with a villous component.
ResultsCumulative rate of development of metachronous advanced adenoma and cancer in the 20-mm group was significantly higher than in the <20-mm group (22.9% vs 9.5%, P<0.001) at 36months. There was also more development of small polyps 5-9mm in the 20-mm group than in the <20-mm group (45.2% vs 28.8%, P<0.001). With respect to metachronous lesions, there were more right-sided colonic lesions in the 20-mm group than in the <20-mm group (78.8% vs 50.0%, P=0.015).
ConclusionHigh incidence rates of development of metachronous neoplastic lesions were detected after resection of colorectal polyps 20mm in size.

• 出版日期2016-3