| Title |
Elective colectomy after colonoscopic polypectomy for unexpected polypoid T1 cancer / |
| Another Title |
Kolektomija po kolonoskopinės piktybinių polipų šalinimo procedūros ir netikėta T1 vėžio histologinė diagnozė. |
| Authors |
Samuolis, Nikas ; Samalavičius, Narimantas Evaldas ; Mickys, Ugnius |
| DOI |
10.15388/LietChirur.2014.3086 |
| Full Text |
|
| Is Part of |
Lietuvos chirurgija.. Vilnius : Vilniaus universiteto leidykla. 2014, t. 13, Nr. 2, p. 92-97.. ISSN 1392-0995. eISSN 1648-9942 |
| Keywords [eng] |
malignant colonic polyp ; endoscopic polypectomy ; lymph node metastases |
| Abstract [eng] |
Objective The treatment of early-stage colorectal cancers removed endoscopically depends on histopathologic findings. The aim of this retrospective study was to assess the benefit–risk balance for patients who underwent colectomy after endoscopic polypectomy of a T1 carcinoma with unfavourable histological factors. Methods From January 1st 2004 to February 28th 2014, twenty-three patients (12 men and 11 women, age median 66 years) who underwent colectomy after endoscopic resection of malignant polyps with T1 carcinoma were included in this retrospective study. Specimens resected after endoscopic polypectomy showed at least one of the two unfavorable factors – no free margin or piecemeal resection. The main objective was to assess the benefit–risk balance of oncological resection performed after polypectomy. The oncological benefit was measured by the lymph node metastasis rate, and the risk was measured by the occurrence of severe (grade III–IV) complications or death. Results The most common localisation of T1 cancer was the sigmoid colon (10 cases, 43.5%) and the upper rectum (9 cases, 39.1%). Nine (39.1%) patients had a well-differentiated adenocarcinoma (G1), while others (14 patients from 23, 60.9%) had a moderately differentiated adenocarcinoma (G2). The main indications for colectomy were the margin of resection ≤ 1 mm (n = 17) and peacemeal resection (n = 7). The most common surgical operation was rectal resection with partial mesorectal excision (9, 39.1%). The oncological benefit of colectomy was reached for two patients (8.7%) who had lymph node metastases. Five patients (21.7%) presented postoperative complications. These complications did not rise surgery risk, because all of them were of I–II grade according to Clavien’s classification. There were no deaths Conclusions. Among the patients who underwent oncological colectomy after endoscopic polypectomy for unexpected polypoid T1 cancer with unfavorable histology (no free margin or peacemeal polypectomy) 8.7% had metastases in the lymph nodes; thus, this study suggests the rationale of oncological surgical resection after endoscopic polypectomy for these patients. |
| Published |
Vilnius : Vilniaus universiteto leidykla |
| Type |
Journal article |
| Language |
English |
| Publication date |
2014 |
| CC license |
|
