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Archivos de Medicina Interna

Print version ISSN 0250-3816On-line version ISSN 1688-423X


TAULLARD, Daniel; GONZALEZ, Nicolás; SANGUINETTI, Alberto  and  PEREZ-GATTO, Jorge. Flat colon polyps in a Montevideo population: histological and endoscopic features; therapy and follow-up. Arch. Med Int [online]. 2009, vol.31, n.2-3, pp.42-45. ISSN 0250-3816.

Introduction: Flat polyps (FPs) are defined endoscopically as mucosal lesions whose height is smaller than their diameter. Their histological types may differ, but those with an adenomatous component may present with advanced histology changes, such as villous components, high grade dysplasia and cancer, thus emphasizing the importance of their diagnosis and therapy. Objectives: To evaluate consecutive cases of FPs that may lead to ellucidate their histology type, amenability to endoscopic resection, risk factors for relapse and complications. Methods: Retrospective selection of endoscopic mucosal resections (EMRs) performed in a 5- ear term in patients presenting with FPs that had a follow-up colonoscopy in a minimal interval of 2 months following the EMR. Results: Of the 40 EMRs enrolled, 70% were adenomas, 5% adenocarcinomas and 25% hyperplasias. More than half the adenomatous FPs showed advanced histological changes in the pathology examination. Fourteen per cent of the adenomatous FPs relapsed, being the fragment excision a risk factor for relapse, with an RR of 4.64 (CI= 0.55-39) versus the en-bloc excision. The complications rate was 5%. Conclusions: Most FPs were adenomas, and many of them presented advanced histology changes. Given the adenomatouse FPs relapse potential, it is recommended to survey the patient endoscopically following the removal, especially in those cases where the EMR procedure was done in fragments. The EMR is a safe procedure, with a low complications rate in this series.

Keywords : Flat polyps; Colonoscopy; Mucosectomy.

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