| Abstract: | Twenty colorectal sessile tumors, with nodular surface aggregates, were endoscopically resected in 20 patients. Among 17 tumors less than 19 mm in diameter, 16 were completely resected in one session and one required piecemeal resection to achieve complete removal. All three lesions measuring over 30 mm were resected piecemeal, and one of these lesions was concurrently heat-probe treated. Thus, all lesions were completely resected endoscopically. Histologically, tubular adenoma was identified in nine resected specimens, tubulovillous adenoma in eight, serrated adenoma in one, and carcinoma in adenoma in two. None of the malignant lesions had invaded the submucosa. Adenomas showing severe atypia and carcinomas in adenomas accounted for 55% of all lesions. These findings indicate that endoscopic mucosal resection is the treatment of choice for sessile tumors with nodular surface aggregates; lesions which cannot be managed by this procedure should be surgically resected. |
