Adenomas of the colon and rectum

Publisher Website
Google Scholar
Abstract
The histopathology of adenomas with changes from the simplest hyperplasia through atypism and various phases of carcinoma is presented. The extent of carcinomatous change present seems to bear a direct proportional relationship to the size of the lesion. There is no controversy regarding the management of adenomas within reach of the sigmoidoscope. Small lesions less than 5 mm in diameter are safely treated by fulguration. Larger lesions are totally excised for biopsy, and further appropriate treatment carried out as indicated. In cases of adenomas requiring laparotomy for removal, there seems fairly general agreement that when the lesions measure less than 1.0 cm it is safe to watch and follow with x-ray observation for changes in size and configuration. In larger colonic lesions, surgical removal is indicated except in those instances where age or poor health make the procedure an undue risk. It is acknowledged that following these precepts an occasional small early carcinoma will be missed. With increasing experience with colonoscopy, we believe that soon most adenomas of the colon will be treated by this method. Transabdominal excision and resection may then be reserved for lesions that for some reason cannot be removed via colonoscopy, and those showing invasive malignancy.

This publication has 22 references indexed in Scilit: