Endoscopic and clinicopathological findings in our consecutive 26 patients (19 males and 7 females, average age : 54.7 y.o.) with colorectal submucosal tumor (SMT) treated by endoscopic polypectomy were compared with those in 186 patients in the Japanese literature. In our series, endoscopic ultrasonography (EUS) was carried out as far as possible to evaluate the size, gross appearance, location in the layer structure and ultrasonic characteristics of the tumors. Endoscopic polypectomy was carried out only when the snare-wire loop was tightened within a few mm in diameter.
The final diagnosis of the 26 cases were 12 lipomas, 7 carcinoids, 3 leiomyomas, 2 lymphangiomas, one hemangioma and one mixed tumor. Complication of transient lower intestinal bleeding was observed after polypectomy only in one case of lipoma. Correct preoperative diagnosis was not obtained from 5 patients, and 3 of whom were not carried out of EUS. The average size of SMTs resected were 10.1 mm in our series and from 7.3 to 18.9 mm in 186 in the literature. The semipedunculated or pedunculated appearance of SMTs were seen in 54% in our series and 69% in the cases in literature.
In conclusion, endoscopic polypectomy can be indicated to colorectal SMTs in the following conditions ; 1) the benign SMT less than 20 mm in diameter showing pedunculated of semipedunculated appearance, and 2) carcinoid tumor less than 10 mm in diameter without any metastasis.
