Original ArticlesClinicopathologic features and endoscopic treatment of superficially spreading colorectal neoplasms larger than 20 mm☆,☆☆
Section snippets
Materials and methods
The clinical and pathologic features of 120 surgically or endoscopically resected LSTs (carpet-type creeping tumor)1, 8, 9 larger than 20 mm in maximum diameter were studied (32 adenomas, 70 in situ carcinomas and 18 submucosally invasive carcinomas). Informed consent was obtained from all patients before each procedure. The lesions were divided into 2 subtypes based on the macroscopic surface appearance at endoscopy. F-type lesions had a flat, smooth surface and were low in height (Fig. 1).
Results
Of the 120 LSTs, 33 were F-type and 87 were G-type lesions. Four colonoscopists differentiated between F- and G-type LSTs during colonoscopy; there was no disagreement as to lesion type among the 4 colonoscopists. In addition, all colonoscopists agreed as to the diagnosis for all lesions on review of archival images obtained during colonoscopy. Thus, there were no instances of inter- or intraobserver variability.
G-type lesions were significantly larger than F-type lesions (33.3 ± 11.4 mm versus
Discussion
The large superficial spreading neoplasm in the colon or rectum, termed LST, has been recognized as an important precursor of advanced colorectal carcinoma. Large numbers of LSTs have been reported and their clinical significance discussed.1, 2, 7, 8 LST was divided into F- and G-types based on detailed observation during chromoendoscopy with indigo carmine dye spraying. Although there are several reports concerning endoscopic excision of giant colorectal polyps,14, 15, 16, 17, 18 there have
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Reprint requests: Shinji Tanaka, MD, PhD, Department of Endoscopy, Hiroshima University School of Medicine, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan.
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Gastrointest Endosc 2001;54:62-6