Colonic Polyps and Coloscopic Polypectomy

Abstract

Colonic polyps are predominantly benign epithelial hyperplasias, adenomas, hamartomas or of inflammatory origin. There seems to be no transition between hyperplastic and adenomatous polyps. The tendency of adenomatous polyps to become malignant is still debated, differences between adenomatous and villous polyps do not exist. The proportion of villous adenomas and carcinomatous polyps increases with increasing diameter of the polyp. The histological pattern of colonic polyps is not always uniform: a sufficient judgement is only possible by serial section of the entire polyp. A polyp is on clinical grounds only malignant when the invasive growth has penetrated the muscularis mucosae. The new developed coloscopic polypectomy is possible with reasonable risk in all segments of the colon. It seems so that this method is becoming the treatEndoscopy 4 (1972) 212-216 0 Georg Thieme Verlag, Stuttgart

Colonoscopy in the management of colon polyps

“…Wolff and Shinya (1973a, b) have recently reviewed their series of over 600 colonoscopic polypectomies. Other published series are small and mainly descriptive (Friend, 1972;Ottenjahn, 1972;Deyhle et al, 1973;Fruhmorgen and Demling, 1973;Testas et a]., 1973;. In reviewing our series of 300 polypectomies in 169 patients we have attempted to put colonoscopic polypectomy in perspective from the clinician's point of view, and have also indicated its problems and limitations.…”

Bipolar Snare Polypectomy – A Safer Technique for Electrocoagulation of Large Polyp Stalks

“…Snare polypectomy through the fibreoptic endoscope is now a routine procedure and one which has revolutionised the management of colon polyps (1,2,3,4). Even large polyps can be removed, "piecemeal" if necessary (5, 6) although many endoscopists feel that polyps with a base of over 2-3 cm should in most cases be removed surgically because of the risk of damage to the bowel wall or incomplete removal of the polyp.…”

Diathermy-Biopsy – A Technique for the Endoscopic Management of Small Polyps

“…Now that techniques for diathermy removal of polyps are generally available (2,4,5,6), it is logical to ablate any polyp seen, on the grounds that histological type cannot be determined by inspection alone and that the lesion may be potentially pre-cancerous. The situation commonly arises during colonoscopic exami-Endoscopy 5 (1973) nation that although the patient has several large polyps the endoscopist notices one or more very small additional polyps which were not suspected on X-ray.…”