The importance of colonoscopy in the treatment of colorectal polyps and colorectal cancer screening.

Ann Ital Chir 2019 Apr 1;8. Epub 2019 Apr 1.

Aim: Colorectal polyp is the most commonly encountered intestinal colon pathology in patients over 50 years of age, and 5% of which develops a "colorectal cancer". The early-stage polyps can be detected and removed endoscopically, which reduce the incidence of carcinoma. Our study is aimed to investigate the role of colonoscopy in colorectal adenoma treatment and screening for colorectal cancers, and to answer the question of whether the colorectal polyps would become malignant or not malignant by means of the comparative analysis of their histological features.

Methods: In the interval between 2011 and 2016 years, endoscopic polypectomy was performed in 118 out of 1375 patients at the Endoscopy Department of the Central Customs Hospital, either with a snare loop and a biopsy clamp. The age group of the patients was between 20 and 65years. A retrospective analysis was performed in 100 of these patients, of whom 18 were later excluded.

Results: Grounding on the histopathological evaluation, adenomatous polyps were differentiated into tubular (65-80%), tubulovillous (25%), and villous (5-10%) adenomas. In particular, 90% of 1 cm (small) polyps were tubular. Dysplasia was found in 42 out of the 100 polyps. The 42 patients with dysplasia were reevaluated, and 26 (61.9%) later developed a malignancy. Malignancy did not occur in the case of any of the 58 polyps without dysplasia. The study also revealed that the size of polyps is directly correlated with their path-morphological structures. In this study, two giant polyps were detected and then treated surgically, one patient had perforation after the polypectomy, and a surgical intervention immediately was performed upon him. During the colonoscopy, three patients had bleeding, hemoclip was applied to one of those patients, and sclerothreapy was performed upon the rest of two patients. After the polypectomy, in two patients, there was a feeling of pain, fever, discomfort in the abdomen, which was assessed as a "postpolypectomy" condition CONCLUSION: Also in our experience adenomatous polyps play a crucial role in the development of colorectal cancer. Therefore, it seems quite essential to avert colorectal cancers gradually. Colonoscopy is a non-invasive method of diagnosis and a treatment of colorectal polyps. Proper and careful colonoscopy examination is indispensable in the discovery of colorectal polyps and subsequent follow-up. Timely and routine colonoscopy is considered as an important approach for thwarting the development of malignant neoplasms.

Key Words: Adenomatous polyps, Colorectal cancer, Colorectal polyps, Post-polypectomy.

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April 2019
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