Endoscopic And Pathological Characteristic And Treatment Of Colorectal Diminutive Polyps

Objective To analyze the endoscopic and pathological characteristics and management of colorectal DP, and to explore reliable evidence for clinical significance and follow-up strategies of colorectal DP.Methods Retrospective analysis for the colorectal polyps ≤5mm of patients undergoing colonoscopy in Fujian Provincial Hospital from Jan.2013 to Dec.2013.Recorded and analyzed the data of location, diameter, morphology,pathological characteristics and management.Results(1)Relevance ratio of colorectal DPRetrospective analysis for the clinical data of 14988 patients undergoing colonoscopy in Fujian Provincial Hospital from Jan.2013 to Dec.2013, there were 3443 patients detected colorectal polyps. A total of 681 patients with 944 cases colorectal DPs were enrolled, which accounted for 19.8% of the polyps cases.(2)The pathological characteristics of colorectal DPThis group of colorectal DP944, 522 cases(55.3%) of adenomatous polyp including 513 cases(98.3%) of tubular adenomatous polyp, 2 cases(0.4%) of tube-villi adenomatous polyp and 7 cases(1.3%) of serrated adenomatous polyp(3 cases of wide base serrated adenoma,4 cases of traditional serrated adenoma). In the 522 cases of adenomatous polyp, there are 411 cases(78.7%)accompanied by low level intraepithelial neoplasia, among them,407 cases of the tubular adenoma with low level intraepithelial neoplasia,2 cases of tubular villous adenoma with low level intraepithelial neoplasia, 2 cases of serrated adenoma intraepithelial neoplasia with a low level intraepithelial neoplasia. 422 cases(44.7%) of the adenomatous polyp, including 62 cases(14.7%) of inflammatory polyp, 358 cases(84.8%) of hyperplastic polyp,2 cases(0.5%).of young sex polyp.358 cases of hyperplastic polyp, with them, there are 4 cases(1.1%)of low level intraepithelial neoplasia. In this study, adenomatous polyp with low level intraepithelial neoplasia is relatively rare.(3)Distribution of gender and age of colorectal DPThere were 560 male and 384 female in this group, the sex ratio of 1.46 :1(P<0.05), the relevance ratio of adenomatous polyp in male higher than female. Age 11~83 years old. There were 368 patients aged less than50 years and 578 patients aged more than or equal with 50 years(P<0.01). the relevance ratio of adenomatous polyp in aged more than or equal with 50 years higher than less then 50 years.(4)Endoscopic characteristics of colorectal DPThe relevance ratio of adenomatous polyp in the rectum and sigmoid colon were higher in colorectal DPs; the relevance ratio of adenomatous polyp in left colonic adenomatous detection rate is higher than the right colon polyp the relevance ratio of adenomatous polyp in the single higher than the multiple. the relevance ratio of adenomatous polyp in more than 3mm higher than less than or equal to 3mm. the relevance ratio of adenomatous polyp in the polyp with iati or stem higher than flat polyp.(5)The management of endoscopy of colorectal DPColorectal DP biopsy forceps pliers in addition to 789 cases(83.6%), the way of snare, hot tongs burning to remove for 193 cases(20.2%), endoscopic mucosal resection(EMR) under hree(0.3%).A great number of flat DPs were resected by biopsy forceps, iati and stem DPs were mainly resected by the way of snare, hot tongs burning, EMR. All DPs were mainly resected by biopsy forceps, but compare with less than or equal with 3mm DPs, more than 3mm DPs were resected by snare, hot tongs burning,EMR even more.Conclusion In recent years, with the rapid development of colonoscopy technology, colorectal DP detection rate has also been gradually increased. Colorectal DP have certain cancer may, also there is a significant clinical significance, we should not be ignored. Colorectal DP detection rate of men than women; And male adenomatoid polyp detection rate is higher than female. Acuity in 50 patients with colorectal DP adenomatous polyp detection rate is higher than the < 50 patients, should pay attention to for more than 50 a broad survey of the elderly. Left colonic with colorectal DP adenomatoid polyp detection rate is higher the right colon polyp. Colorectal DP is given priority to with biopsy forceps pliers in addition to the more. Colorectal DP have potential of malignant change, should be regular follow-up after endoscopic resection.