Treating colorectal polypoid neoplasms during a colonoscopy.

Background: To evaluate the efficacy and outcomes of endoscopic treatment for colorectal polypoid neoplastic lesions.

Methods: From September 1999 to May 2003, 11,447 consecutive colonoscopic examinations were performed in 9864 patients, totaling 5355 endoscopic polypectomies for colorectal polypoid neoplasms. According to the macroscopic characteristics, the neoplasms were classified into protruded (n = 3953) and sessile (n = 1402) ones. A snare polypectomy was conducted on 3987 lesions and hot biopsy forceps removal on 1368 lesions.

Results: Histological diagnoses included 4456 neoplastic lesions (4282 adenomas and 174 adenocarcinomas) and 899 non-neoplastic lesions (889 hyperplastic and 10 inflamed polyps). For the adenocarcinoma group, 24 instances involved submucosal invasion or an unclear resection margin, and these patients received a further operation, while 11 surgical specimens disclosed no residual tumors. Three (0.05%) perforations and 96 (1.8%) instances of bleeding were found following endoscopic polypectomy. No procedure-related mortality was found, and no recurrent malignancy was found after 14 to approximately 56 months of follow-up.

Conclusions: To lower the incidence of and mortality from colorectal cancer, endoscopic polypectomy for colorectal polypoid neoplasms is an effective and safe procedure.