Conduite a tenir apres exerese endoscopique des polypes degeneres ou des cancers polypoides colo-rectaux experience d'un service de chirurgie colo- rectale

Background: endoscopic polypectomy is a safe and effective treatment for most patients with non-sessile colorectal polyps. However in those containing a focus of invasive carcinoma (malignant polyp -MP) or in small polypoid carcinomas (SPC) the need for radical resection remains controversial. The aim of this study was to identify indicators for adverse outcomes in such patients. Methods: between June 1977 and January 1995, 55 patients at Concord Hospital had an initial endoscopic polypectomy with removal of 38 MP and 17 SPC. In 26 patients the lesion was treated by polypectomy alone and 29 had an additional surgical resection. Results: adverse outcome after polypectomy was associated only with incomplete or doubtful endoscopic excision (p = 0.008) or incomplete or doubtful histological clearance (p = 0.002). Conclusions: these results support polypectomy alone as a safe and effective method of treatment for most malignant polypoid tumours provided that the tumour is endoscopically and histologically totally excised.