当前位置： SCI文献检索 > SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY期刊下所有文献 > High-grade dysplastic adenoma-like mass lesions are not an indication for colectomy in patients with ulcerative colitis.

High-grade dysplastic adenoma-like mass lesions are not an indication for colectomy in patients with ulcerative colitis.

Abstract：

OBJECTIVE:The management of high-grade dysplasia (HGD) in polypoid lesions in patients with ulcerative colitis (UC) is not well characterized. The purpose of this study was to characterize the clinical course of patients with HGD in adenoma-like dysplasia-associated lesion or masses (DALMs) in the absence of any synchronous flat dysplasia. We hypothesize that colectomy is not warranted in patients who undergo complete excision of adenoma-like DALMs with HGD in UC. MATERIAL AND METHODS:Pathology and clinical databases were systematically searched for the presence of dysplastic lesions in inflammatory bowel disease from 1997 to 2004. Patients with UC who had adenoma-like DALMs were identified, and a subset with HGD lesions was defined as our study cohort. RESULTS:A total of 102 patients with UC were identified. Thirty of them (29%) had adenoma-like DALMs without synchronous flat dysplasia; 9 of these patients (30%) had HGD in these lesions. Thirty-two surveillance colonoscopies were performed in this cohort (mean 3.6 colonoscopies/patient). The patients were followed for a mean of 76.5 months (52-99 months). Three out of 9 patients (33%) had colectomy. None of the patients in this cohort was detected to have carcinoma in surveillance biopsies and/or in the resection specimens. CONCLUSIONS:Our data suggest that the presence of HGD in DALMs does not warrant colectomy. Continued close observation is suggested in this patient cohort after complete excision of polyps. Further prospective evaluation of this patient population is merited.

journal_name

Scand J Gastroenterol

journal_title

Scandinavian journal of gastroenterology

authors

Blonski W,Kundu R,Furth EF,Lewis J,Aberra F,Lichtenstein GR

doi

10.1080/00365520801909686

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

817-20

issue

7

eissn

0036-5521

issn

1502-7708

pii

790575636

journal_volume

43

pub_type

杂志文章

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