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Adénomes bénins et adénomes dégénérés du côlon. Expérience de 12 ans de polypectomie endoscopique

Adenomas and adenomas containing carcinoma of the large bowel. 12 years experience in endoscopic polypectomy

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Acta Endoscopica

Résumé

Les adénomes porteurs d’un carcinome invasif constituent la majorité des cancers colo-rectaux au début. Au cours des douze dernières années, 3 600 polypes ont été réséqués par voie coloscopique chez 1 936 patients.

69 adénomes porteurs d’un carcinome invasif ont été décelés chez 69 patients.

Les paramètres histopathologiques rendent possible la distinction entre les cas à haut et à faible risque de métastases lymphatiques.

Une comparaison a été établie entre la polypectomie endoscopique seule chez les patients à faible risque, et la chirurgie chez les patients à haut risque.

52 cas à risque faible ont été traités par polypectomie endoscopique sans chirurgie ; 17 malades ont subi une intervention chirurgicale.

Aucune métastase à distance n’a été objectivée dans le groupe polypectomisé ; des ganglions lymphatiques métastatiques ont été trouvés après intervention chez 40 % des patients à haut risque.

Ces résultats confirment l’attitude thérapeutique adoptée chez les patients à faible risque ; par contre chez les patients à haut risque, une évaluation histo-pathologique soigneuse est indispensable.

Summary

Adenomas containing invasive carcinoma are the majority of early colorectal cancers.

In the last 12 years about 3 600 polyps have been removed by colonoscopic polypectomy in 1936 patients.

69 adenomas containing invasive carcinoma have been found in 69 patients.

Pathological parameters make it possible to distinguish between high and low risk cases of limphnode metastases.

Endoscopic polypectomy alone in low risk patients has been compared to major surgery in high risk cases.

52 low risk cases have been treated only by E.P. ; 17 patients underwent surgery.

No distant metastases have been so far evidenced in the polypectomy group ; limphnode metastases have been found at operation in 40 % of high risk cases.

The observed results confirm the value of the actual therapeutic policy in low risk patients ; in high risk cases a careful pathological evaluation is mandatory.

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Author notes

  1. F. P. Rossini

    Present address: Dept. of Oncology, Gastroenterology, Gastrointestinal Endoscopy Service, Ospedale S. Giovanni, Via Cavour 31, 10123, Torino, Italy

Authors and Affiliations

  1. Dept. of Oncology, Gastroenterology, Gastrointestinal Endoscopy Service, Ospedale S. Giovanni, Via Cavour 31, 10123, Torino, Italy

    S. Coverlizza & M. Risio

Authors
  1. F. P. Rossini
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  2. A. Ferrari
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  3. S. Coverlizza
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  4. M. Spandre
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  5. M. Risio
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  6. C. Gemme
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  7. C. Cavallero
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Rossini, F.P., Ferrari, A., Coverlizza, S. et al. Adénomes bénins et adénomes dégénérés du côlon. Expérience de 12 ans de polypectomie endoscopique. Acta Endosc 17, 137–143 (1987). https://doi.org/10.1007/BF02968599

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  • DOI: https://doi.org/10.1007/BF02968599

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