Management of the malignant polyp.

Abstract:

:In the United States, the prevalence of adenomatous polyps found during colonoscopic evaluation ranges from 25 to 41%, and of these, 2 to 5% contain invasive malignancy. The management of the malignant polyp continues to be challenging. Endoscopic resection by polypectomy has been shown to be sufficient for management of certain polyps containing cancer; however, it is important to keep in mind that polypectomy does not remove the lymph node drainage basin and may be an inadequate resection for some adenocarcinoma containing polyps that have specific histologic features. Depth of invasion has been shown to correlate with the risk of lymph node metastasis. Other unfavorable histologic features include lymphovascular invasion, poor differentiation, inability to assess margin (piecemeal resection), and positive resection margin (< 2 mm); these are important factors to consider in management. For these patients formal oncologic surgical resection is indicated. Traditional open or laparoscopic procedures are routinely used for colectomy in these patients. Following polypectomy or segmental colectomy, surveillance of these patients is critical, and can lead to excellent long-term outcomes.

journal_name

Clin Colon Rectal Surg

authors

Ramirez M,Schierling S,Papaconstantinou HT,Thomas JS

doi

10.1055/s-0028-1089944

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

286-90

issue

4

eissn

1531-0043

issn

1530-9681

journal_volume

21

pub_type

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