Neoplastic Colonic Polyp

Neoplastic Colonic Polyps Dr. Saud Al-Subaie Department of Surgery Amiri Hospital Monday 17/04/2006

Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],Classification of polyps ,[object Object],[object Object],[object Object],[object Object],Neoplastic Non- Neoplastic

Epidemiology 10.5% (100 %) Weighted chance 40 % 10 % Villous adenoma 22% 15 % Tubulovillous 5% 75% Tubular adenoma % Malignant Prevalence TYPE

Size and % of Ca 54% 10% 10% Villous 45% 9% 4% Tubulo-villous 34% 10% 1 % Tubular > 2cm 1-2 cm < 1cm

Etiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Endoscopic Management ,[object Object],[object Object],[object Object],[object Object],[object Object]

Adenoma With Ca Adenoma With Ca

What is next ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Malignant Polyp ,[object Object],[object Object],[object Object],[object Object],[object Object]

Haggitt Highest Invasion of submucosa, not the muscularis propria, sessile polyp 4 Moderate Invasion of the (MM)& polyp stalk 3 Low Invasion of the (MM) & polyp neck 2 None Invasion of the (MM) & polyp head 1 None No invasion of the muscularis mucosa (MM), carcinoma in situ 0 Risk of LN mets Histologic description level

Histologic assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Histological assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cesare Hassan et al ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dis Colon Rectum 2005

Cesare Hassan et al ,[object Object],[object Object],[object Object],[object Object],Dis Colon Rectum 2005

Cesare Hassan et al ,[object Object],[object Object],Dis Colon Rectum 2005

Sitz et al ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dis Colon Rectum 2004

Sitz et al ,[object Object],[object Object],[object Object],Dis Colon Rectum 2004

Volk / Fazio ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gastroenterology 1995

Operative Management ,[object Object],[object Object],[object Object],Malignant rectal polyps Anatomic resection with removal of adjacent LN Malignant / incompletely excised / Suspicious polyp - Colotomy+ Polypectomy - Segmental Resection Benign polyp(>3cm can’t be managed endoscopically) Surgical options Type of polyp

Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

“ Colon cancer can only be found if looked for. And it can only be cured if found early.”

Neoplastic Colonic Polyp

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