Abstract

POLEO, José Ramón. Small polyps: what to do about them?. Gen [online]. 2012, vol.66, n.1, pp.15-19. ISSN 0016-3503.

Introduction: Several strategies have been proposed recently to diminish risks and costs such as the extirpation of diminutive polyps without histologic study, or leaving them in situ when their endoscopic characteristics allow to predict their non-neoplastic potential. Objective: To determine the nature of diminutive (5 mm diameter or less) polyps in a number of colonoscopies and the clinical impact of resecting them without histologic study or to leave them in situ without resection. Patients and methods: 271 colonoscopies were performed consecutively, with resection and histopathological study of all the polyps detected. Results: 26/63 diminutive polyps (41,26%) presented carcinogenic potential, with the inherent risk for the patient if they were leaved in situ, or with inapropiate information to determine the time of surveillance in case of having resected and discarded the polyps without histologic evaluation (2 high grade dysplasia between them). Conclusions: 1. A high percentage of diminutive polyps have a carcinogenic potential and its microscopic structure must be adequately evaluated. 2. The progress of high resolution endoscopy with magnification and chromoendoscopy, may contribute to the application of policies such as resect and discard.

Keywords : colonoscopy; diminutive and small polyps; endoscopic polipectomy.