scholarly journals Sessile serrated adenoma invading a diverticulum in the right colon: tips and tricks for a safe complete endoscopic resection

Endoscopy ◽  
2021 ◽  
Author(s):  
Sophie Geyl ◽  
Jérémie Albouys ◽  
Romain Legros ◽  
Hugo Lepetit ◽  
Martin Dahan ◽  
...  
2016 ◽  
Vol 83 (5) ◽  
pp. AB231-AB232
Author(s):  
Shawn Kaye ◽  
Mohit Mittal ◽  
Katherine Kim ◽  
William E. Karnes

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Kaoru Omori ◽  
Kanako Yoshida ◽  
Sadafumi Tamiya ◽  
Tsutomu Daa ◽  
Masahiro Kan

A sessile serrated adenoma/polyp (SSA/P) with cytological dysplasia in the right colon, which transformed to an invasive submucosal adenocarcinoma finally, was endoscopically observed in a 76-year-old woman. A whitish soft SSA/P (approximately 25 mm in diameter) was detected in the cecum. Biopsy samples were obtained from the small nodule, and the lesion was eventually diagnosed as an SSA/P with cytological dysplasia, considering endoscopic observations, among which the narrow-band imaging features suggested that the lesion was adenomatous, that is, a round-oval pattern, and hyperplastic, that is, comprising a circular pattern with dots and an invisible capillary vessel. After 11 months, an SSA/P had rapidly developed into a submucosal adenocarcinoma with lymphatic infiltrations, and the most aggressive deep invasion was observed in the central depression. This case suggests that right-side SSA/Ps with cytological dysplasia should be removed immediately, considering the potential for rapid progression to a larger size and eventually to deep and extensive cancer.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Naohisa Yoshida ◽  
Yutaka Inada ◽  
Ritsu Yasuda ◽  
Takaaki Murakami ◽  
Ryohei Hirose ◽  
...  

Background and Aims. Missed polyps are a pitfall of colonoscopy. In this study, we analyzed the efficacy of an additional 30 seconds observation using linked color imaging (LCI) for detecting adenoma and sessile serrated adenoma/polyp (SSA/P). Materials and Methods. We enrolled patients undergoing colonoscopy from February to October 2017 in two institutions. In all patients, the cecum and ascending colon were observed with white light imaging (WLI) first. The colonoscope was inserted again, and the cecum and ascending colon were observed for an additional 30 seconds using either LCI or WLI. The method for the 30 sec observation was to insufflate the cecum and ascending colon sufficiently and observe them in a distant view, because the length of the second observation was determined to be precisely 30 sec. For the second observation, LCI was performed for the first 65 patients and WLI for the next 65. Adenoma and SSA/P detection rate (ASDR) in the second observation were examined in both groups. According to a pilot study, the sample size was estimated 65. Results. In the first observation, ASDR were 30.7% in the LCI group and 32.2% in the WLI group (p=0.85). For the second observation, 13 polyps were detected in the LCI group and 5 polyps in the WLI group (p=0.04). Additionally, ASDR for the second observation were 18.5% and 6.1%, respectively (p=0.03). There were no significant differences between the LCI and WLI groups with respect to morphology (ratio of polypoid) (38.5% versus 60.0%, p=0.52) and histology (ratio of adenoma) (92.3% versus 100.0%, p=0.91). Total adenoma and SSA/P number were 48 in the LCI group and 36 in the WLI group (p=0.02). Conclusion. The 30 seconds additional observation with LCI improved the detection of adenoma and SSA/P in the right-sided colon.


2016 ◽  
Vol 04 (04) ◽  
pp. E451-E458 ◽  
Author(s):  
Hirotsugu Saiki ◽  
Tsutomu Nishida ◽  
Masashi Yamamoto ◽  
Shiro Hayashi ◽  
Hiromi Shimakoshi ◽  
...  

2020 ◽  
Vol 29 (2) ◽  
pp. 175-179
Author(s):  
Melania Macarie ◽  
Simona Bataga ◽  
Simona Mocan ◽  
Monica Pantea ◽  
Razvan Opaschi ◽  
...  

Background and Aims: The importance of sessile serrated lesions (SSLs) in the pathogenesis of colorectal carcinoma has been recently established. These are supposed to cause the so-called “interval cancer”, having a rapidly progressive growth and being difficult to detect and to obtain an endoscopic complete resection. We aimed to establish the most important metabolic risk factors for sessile serrated lesions. Methods: We performed a retrospective case-control study, on a series of 2918 consecutive patients who underwent colonoscopy in Gastroenterology and Endoscopy Unit, County Clinical Emergency Hospital, Târgu-Mureș, Romania between 1 st of January 2015-31 th of December 2017. In order to evaluate the metabolic risk factors for polyps’ development, enrolled participants were stratified in two groups, a study group, 33 patients with SSLs lesions, and a control group, 138 patients with adenomatous polyps, selected by systematic sampling for age and anatomical site. Independent variables investigated were: gender, smoking, alcohol consumption, obesity, arterial hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, nonalcoholic liver disease. Results: For SSLs the most common encountered localization was the right colon in 30.55% of cases. By comparative bivariate analysis between SSLs group and control group, it was observed that hypertension (p=0.03, OR 2.33, 95 %CI 1.03-5.24), obesity (p=0.03, OR 2.61, 95 %CI 1.08-6.30), hyperuricemia (p=0.04, OR 2.72, 95 %CI 1.28-7.55), high cholesterol (p=0.002, OR 3.42; 95 %CI 1.48-7.87), and high triglycerides level (p=0.0006, OR 5.75; 95 %CI 1.92-17.2) were statistically associated with SSLs development. By multivariate analysis hypertension and hypertriglyceridemia retained statistical significance. Conclusions: Our study showed that the highest prevalence of SSLs was in the right colon and hypertension and increased triglycerides levels were associated with the risk of SSLs development. These risk factors are easy to detect in clinical practice and may help identifying groups with high risk for colorectal cancer, where screening is recommended.


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