Abstract

Aim: In this study, we aimed to investigate patients with colorectal polyps who underwent surgical resection due to unsuccessful endoscopic removal.

Metod: Patients who underwent surgical resection for colorectal polyps in our service between January 2014 and August 2017 were included in this study. Demographic information of the patients, localization of polyps, endoscopic biopsy results, surgical procedures performed, polyp histopathology in resection material and postoperative complication situation were examined retrospectively in the hospital database of the regarding cases.

Results: Eight patients went to surgical resection with the diagnosis of "difficult" polyps within this specified period in our clinic. Six of the patients were male (6/8) and the mean age was 64.12. Localization of the polyps were rectum in 3 patients (3/8), ascending colon in 2 (2/8), descending colon in another 2 (2/8) and transverse colon in 1 patient (1/8). The preoperative endoscopic biopsies of the patients were reported as villous adenoma in five (5/8), tubular adenoma in 2 (2/8) and juvenile polyp in 1 (1/8). Pathological examination of the removed specimens revealed villous adenomas + high grade dysplasia (HGD) in 3 (3/8) patients, tubular adenoma + HGD in 1 (1/8), tubular adenoma + intramucosal carcinoma in 1 (1/8), juvenile polyp + low grade dysplasia (LGD) in 1 (1/8) and 2 (2/8) invasive carcinomas. Cancer stages have been reported as T1N0M0 and T3N0M0 in patients with invasive carcinoma. The largest size of the extracted polyps was 13.5x8.5 cm while the size of the smallest one was 4x3 cm. Interestingly, the smallest tumor were invasive tumors.

Conclusion: The size of the polyp is not a clear determinant of the probability of invasive carcinoma before surgery. We believe that polyps that can not be removed by endoscopic or local resection techniques should be removed according to the principles of oncologic surgery regardless of endoscopic biopsy results.