Abstract
A RETROSPECTIVE analysis of 2124 colonoscopies was carried out. Most were performed as day cases under sedation. Abnormalities were detected in 59% of the colons examined; polyps were detected in 24% and almost half of these had more than one polyp. The detection rate was higher in males than females. Most polyps were left sided. Increasing size of polyp was associated with a higher proportion of villous elements and more frequent malignant change. The pattern of histological types was comparable to other large published series. Carcinoma was detected in 5% of adenomatous polyps, mainly in larger villous lesions. Twenty-nine polyps were malignant; these were also predominantly left sided. Applying the St. Mark’s criteria, no polyp with malignant change which was considered completely excised by endoscopic polypectomy has recurred or metastasized at follow up. In contrast, those polyps considered incompletely excised had a high (80%) incidence of residual tumour. The current controversies in the management of malignant colorectal polyps are discussed.
Published Version
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