Abstract
In a period of the recent 5 years and 6 months, 89 lesions in 87 cases have been removed in a piecemeal fashion endoscopically. From the pathological point of view, 100 specimens taken in a piecemeal fashion were examined for the adequacy of orientation and margin of excision. The results were as follows; 1) Microscopic orientation of the tissues was excellent in 5.3% (5 mm or less than 5 mm in diameter), in 62.2% (69 mm), in 80.8% (1014 mm) and in 100% (more than 15 mm in diameter). Larger specimens more than 10mm in diameter were considered easier to make an accurate diagnosis pathologically. 2) However, tissues including the mucosal muscle were present in all, 6 mm or more in maximal diameter. In these groups, it was sufficient to diagnose adenomas and focal carcinomas. 3) The colonoscopist has to cut the specimens from the base to the head of the polyp and divide them into two fragments (proportion ratio 7 : 3) in order to show the submucosa and excisional margin accurately. Therefore, well oriented fragments, which give much detailed information pathologically, can be obtained even in piecemeal speci mens.
