Lu Quan, Peng Quan-Zhou, Wang Li-Sheng, Yao Jun, Li De-Feng
Department of Gastroenterology, Shenzhen People's Hospital (the Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China.
Department of Pathology, Shenzhen People's Hospital (the Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China.
Asian J Surg. 2024 Jan;47(1):195-200. doi: 10.1016/j.asjsur.2023.07.027. Epub 2023 Aug 2.
Serrated polyps are considered the precursor lesions of colorectal cancer through the serrated pathway. In the present study, we aimed to evaluate and discuss the clinical and endoscopic characteristics and management of serrated polyps.
The data of 220 cases with serrated polyps between September 2018 and November 2021 in Shenzhen People's Hospital were retrospectively analyzed.
Of all these cases, 32 were hyperplastic polyps, 36 were traditional serrated adenomas, 126 were sessile serrated lesions, 25 were SSLs with dysplasia, and one was an unclassified serrated adenoma. Although most patients were males aged ≥50 years and most serrated polyps were located in the distal colon and rectum with a size of 6-10 mm and the shape of type 0-Is, there was no significant difference (P > 0.05). Serrated polyps of ≤5 mm in size and type 0-IIa were mostly removed by cold biopsy forceps. Cold snare polypectomy was primarily used for those of 6-10 mm in size. Endoscopic mucosal resection was used for those of 6-20 mm, and endoscopic submucosal dissection was used for those of ≥20 mm (P < 0.05). All complications occurred in SSL patients with or without dysplasia (P < 0.05).
Clinical and endoscopic characteristics were beneficial for distinguishing and diagnosing serrated polyps. In addition, management options were crucial to prevent recurrence and progression. However, the detection rate of serrated polyps was relatively low. Therefore, prospective multicenter studies with large samples are necessary to better assess colorectal serrated polyps.
锯齿状息肉被认为是通过锯齿状途径发展为结直肠癌的前驱病变。在本研究中，我们旨在评估和讨论锯齿状息肉的临床及内镜特征与处理方法。
回顾性分析2018年9月至2021年11月期间深圳市人民医院收治的220例锯齿状息肉患者的数据。
在所有这些病例中，32例为增生性息肉，36例为传统锯齿状腺瘤，126例为无蒂锯齿状病变，25例为伴发育异常的无蒂锯齿状病变，1例为未分类的锯齿状腺瘤。尽管大多数患者为年龄≥50岁的男性，且大多数锯齿状息肉位于结肠远端和直肠，大小为6 - 10毫米，形态为0-Is型，但差异无统计学意义（P > 0.05）。直径≤5毫米且为0-IIa型的锯齿状息肉大多通过冷活检钳切除。冷圈套息肉切除术主要用于直径6 - 10毫米的息肉。直径6 - 20毫米的息肉采用内镜下黏膜切除术，直径≥20毫米的息肉采用内镜黏膜下剥离术（P < 0.05）。所有并发症均发生在伴或不伴发育异常的无蒂锯齿状病变患者中（P < 0.05）。
临床和内镜特征有助于锯齿状息肉的鉴别诊断。此外，处理方式对于预防复发和进展至关重要。然而，锯齿状息肉的检出率相对较低。因此，有必要开展前瞻性、多中心、大样本研究以更好地评估结直肠锯齿状息肉。
