Colorectum: Mucosal Neoplasias

  • Andrej Wagner
  • Tadateru Maehata
  • Frieder BerrEmail author
  • Naohisa Yahagi


To minimize the risk for interval cancer after colonoscopy, we need to improve detection of small (<10 mm) and minute (<5 mm) flat-type neoplasias and inconspicuous laterally spreading tumors, and we aim to analyze neoplasias for risk of superficial or invasive cancer. Currently, endoscopic en bloc resection yields poor curative resection rates outside East Asia, mainly owing to non-exclusion of deep sm2–3 invasive colorectal cancer lesions. Therefore, we focus on endoscopic distinction of benign lesions versus malignant neoplasias, and of superficial versus deep submucosa-invasive (sm2–3) early colorectal cancer; both distinctions are required to determine indications for endoscopic en bloc resection or surgery.


Early colorectal neoplasias Vessel pattern Surface/pit pattern Adenomas, serrated and classic Adenocarcinoma Lateral spreading tumors Submucosal cancer invasion Endoscopic resection, indications Surgical resection, indications 



We gratefully acknowledge the contribution of some cases by Dr. Tsuneo Oyama of Nagano, Japan, and the contribution of histology by Dr. Daniel Neureiter and Dr. Tobias Kiesslich, Salzburg, Austria.


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Copyright information

© Springer International Publishing 2019

Authors and Affiliations

  • Andrej Wagner
    • 1
  • Tadateru Maehata
    • 2
  • Frieder Berr
    • 3
    Email author
  • Naohisa Yahagi
    • 2
  1. 1.Department of Internal Medicine IUniversity Hospital, Paracelsus Medical UniversitySalzburgAustria
  2. 2.Division of Research and Development for Minimally Invasive Treatment, Cancer CenterKeio University School of MedicineShinjuku-kuJapan
  3. 3.Department of Internal Medicine IParacelsus Medical UniversitySalzburgAustria

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