抄録
A clinicopathological study was made on the endoscopic polypectomy of the large bowel, besed on 181 lesions (153 cases) which had been experienced in the period from September, 1972 to December, 1976 at the Cancer Institute Hospital, and the following results were obtained. 1) Of 181 polypectomized materials, 132 lesions were histologically diagnosed as benign, and 49 lesions were regarded as to be clinically malignant, including those which were histologically diagnosed as borderline atypia and malignant. 2) As with the size of the polypectomized materials, those smaller then 2.0cm comprised 91% (164/181), and as with the macroscopic form, 77% of them were pedunculated. 3) Of 34 lesions which were histologically diagnosed as malignant, 28 lesions were focal carcinomas and 6 of them were invasive carcinomas. All the focal carcinomas were pedunculated in the macroscopic form, while 4 lesions of the invasive carcinoma were subpedunculated and 2 lesions of them were sessile. Five lesions of the invasive carcinoma were referred to colectomy and the remaining cancerous tissue was found in 2 lesions. No lymph node metastasis was found in all the colectomized lesions. 4) The polypectomized site was histologically examined in 23 lesions and it was disclosed that 21 lesions of them were found to be in the state of ulcer or ulcer scar which did not reach the proper muscle layer (Ul-II or UI-Os). It was confirmed that the polypectomy was safely performed in most cases without doing any damage to the proper muscle layer. It was also confirmed that an ulcer which was caused by the polypectomy healed completely in approximately 60 days in most cases.5) The endoscopic polypectomy is indicated for pedunculated and subpedunculated lesions without limit of their size on the ground that it can be performed safely with no technical difficulty. However, it is not indicated for sessile lesions larger than 1.0cm because most of them are invasive carcinoma or advanced carcinoma which eventually requires colectomy.
