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Histologic Changes at the Polypectomy Site of the Colon and Rectum Masakazu Maruyama 1 1Department of Internal Medicine, Cancer Institute Hospital pp.1063-1076
Published Date 1985/10/25
DOI https://doi.org/10.11477/mf.1403109728
  • Abstract
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 Macroscopic and histologic change occurring at polypectomy site was studied, based on 55 operated materials which had been obtained in a period 11 years from 1973 to 1983 at the Cancer Institute Hospital, and the following results were obtained.

 1) Ulcer extending only to the submucosal layer (Ul-Ⅱ) was observed in 74.5% (41/55), which corresponded to the number of cases in which endoscopic polypectomy was safely performed. 2) Polypectomy of pedunculated and subpedunculated lesion caused Ul-Ⅱ grade of ulcer in most cases irrespective of its size, while polypectomy of sessile lesion caused various depth of ulcer, depending on its size. Ul-Ⅱ grade of ulcer was observed in the sessile lesion measuring less than 17 mm in the greatest diameter, and ulcer involving the propria muscle (Ul-Ⅲ) and penetrating through it (Ul‐Ⅳ) was observed in the lesions measuring larger than 18mm. 3) Ulcer of the polypectomy site was repaired 30 days after polypectomy in most cases, regardless of size and form of lesion, and depth of ulcer. 4) There were 15 lesions with remaining cancer at the polypectomy site. Thirteen cases of them were invasive cancer with massive submucosal invasion which could not be removed completely by polypectomy. 5) There were three recurrent cancers. One of them had remained in the mucosal membrane, but the other two had developed into advanced cancer. The polypectomized specimen of these advanced cancers was diagnosed as invasive cancer with marked mucus production in addition to massive submucosal invasion.

 Strict follow-up with short intervals is required in order to detect loeal recurrent cancers in early operatrve stage.


Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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