caa a22 4500 475801784 CHVBK 20180406123739.0 cr unu---uuuuu 170329e20000901xx s 000 0 eng 10.1007/s002680010144 doi (NATIONALLICENCE)springer-10.1007/s002680010144 Endoscopic Management of Polypoid Early Colon Cancer [Elektronische Daten] [Christopher B. Williams, Brian P. Saunders, Ian C. Talbot] Endoscopic management of polypoid early colonic cancer (malignant polyps and polypoid carcinomas) is no longer controversial. When the endoscopist is satisfied that excision is complete and histology is "favorable" (a resection margin of 2 mm and well or moderately well differentiated tumor), surgery is unnecessary. When histology shows "unfavorable" characteristics (which a few histologists still take to include invasion into lymphatics), surgical or laparoscopic resection may be indicated, providing the patient is considered at suitable risk. Surgery kills some patients without finding residual cancer and cannot save others with metastases, so it should be recommended only with due clinical consideration. Sessile or broad-based polyps, especially those in the rectum, are more likely to be "high risk" and merit specialist management if local removal is to be attempted and to allow proper histologic assessment. Endoscopic approaches such as saline injection polypectomy, india-ink tattooing, and use of the argon beam coagulator are applicable in some cases. New approaches that still require trials include ultrasonographic probes, which occasionally clarify the degree of invasion, and prototype stapling devices to allow full-thickness histologic specimens to be obtained. Société Internationale de Chirurgie, 2000 Williams Christopher B. Wolfson Unit for Endoscopy,, St. Mark's Hospital for Colorectal and Intestinal Disorders,, Northwick Park, Watford Road, Harrow, London HA1 3UJ, United Kingdom aut Saunders Brian P. Wolfson Unit for Endoscopy,, St. Mark's Hospital for Colorectal and Intestinal Disorders,, Northwick Park, Watford Road, Harrow, London HA1 3UJ, United Kingdom aut Talbot Ian C. Academic Department of Pathology,, St. Mark's Hospital for Colorectal and Intestinal Disorders,, Northwick Park, Watford Road, Harrow, London HA1 3UJ, United Kingdom aut World Journal of Surgery Springer-Verlag 24/9(2000-09-01), 1047-1051 0364-2313 24:9<1047 2000 24 268 https://doi.org/10.1007/s002680010144 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002680010144 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Williams Christopher B. Wolfson Unit for Endoscopy,, St. Mark's Hospital for Colorectal and Intestinal Disorders,, Northwick Park, Watford Road, Harrow, London HA1 3UJ, United Kingdom aut NATIONALLICENCE 700 1- Saunders Brian P. Wolfson Unit for Endoscopy,, St. Mark's Hospital for Colorectal and Intestinal Disorders,, Northwick Park, Watford Road, Harrow, London HA1 3UJ, United Kingdom aut NATIONALLICENCE 700 1- Talbot Ian C. Academic Department of Pathology,, St. Mark's Hospital for Colorectal and Intestinal Disorders,, Northwick Park, Watford Road, Harrow, London HA1 3UJ, United Kingdom aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/9(2000-09-01), 1047-1051 0364-2313 24:9<1047 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer