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Clinical Management Of Endoscopically Unresectable Colorectal Polyps

Orhan Agcaoglu, MD1, Onur Bayram, MD1, Burak Ilhan, MD2, Derya S Uymaz, MD1, Cagri Bilgic, MD1, Metin Keskin, MD2, Emre Balik, MD1, Sumer Yamaner, MD3. 1Koc University, School of Medicine, Department of General Surgery, 2Istanbul University, Istanbul School of Medicine, Department of General Surgery, 3Istanbul Florance Nightingale Hospital

Background: Resection of some polyps can present technical challenges to remove endoscopically due to their difficult location or size. Our aim was to show the management of polyps that are not suitable for endoscopic polypectomy which requires surgical intervention, and evaluate the malignancy incidence of these polyps.

Materials and methods: Between 1996 – 2012, a total of 16996 colonoscopic examinations and 3875 polypectomies were performed at our Surgical Endoscopy Unit. From these polypectomies, 74 (3%) which were not suitable for endoscopic removal and required surgical intervention were included to the study. Polyp size, characteristics, location, histopathological fetures, final pathological results of specimens, and patient demographics were analyzed. Data were analyzed retrospectively from a prospectively maintained clinical database.

Results: The mean age of the patients was 55 years (range 15-89). The most common histological type was tubulovillous adenoma (41%), and the rest included, hyperplastic polyps (37%) and tubular adenoma (22%). The majority of non-resectable polyps were located at sigmoid colon (28%) and rectum (23%). Statistically the most significant result was the diversity of histopathological evaluation between biopsy and surgical specimen with p value of 0.04.

Conclusion: Our study results show a significant difference between biopsy and final pathology of surgical specimen for unresectable polyps. According to the difference between histopathological evaluation we recommend these patients to undergo radical surgery without an unnecessary preoperative endoscopic biopsy.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 80035

Program Number: P349

Presentation Session: Poster (Non CME)

Presentation Type: Poster

85

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