Clinical experience of large colorectal laterally spreading tumor in a regional hospital: 2‐year results

• Published in: Advances in Digestive Medicine 2014-06, Vol.1 (2), p.38-42
• Main Authors: Hsu, Wen‐Hsin, Sun, Meng‐Shun, Lo, Hoi‐Wan, Tsai, Ching‐Yang, Tsai, Yu‐Jou, Chen, Pao‐Huei
• Format: Article
• Language: English
• Subjects: Colorectal laterally spreading tumor; Endoscopic mucosal resection; Endoscopic submucosal dissection; Nonpolypoid colorectal neoplasm
• ISSN: 2351-9800; 2351-9797; 2351-9800
• DOI: 10.1016/j.aidm.2013.09.001

Summary Background Nonpolypoid colorectal neoplasm has been widely recognized in the past few years. Among nonpolypoid colorectal neoplasms, laterally spreading tumor (LST) is a unique and distinct category in that the tumor grows horizontally with a size >1 cm. It may be easily overlooked during colonoscopy. If the size of the colorectal LST is >2 cm, achieving definite management is also another concerning issue. The aim of this study was to improve our understanding of LST by reviewing its clinical manifestations. Methods All the large colorectal LSTs that were diagnosed and managed at our hospital in the past 2 years were reviewed. Basic demographic data were recorded. LSTs were divided into granular (G) and nongranular types (NG), then further subdivided into nodular mixed and homogeneous types for the G group and flat elevated and pseudodepressed types for the NG group. Results A total of 28 LST in 28 patients were enrolled, with males being more predominant than females (male/female: 18/10). Mean age of the patients and mean size of the LST were 62.6 ± 9.75 years and 3.4 ± 1.257 cm, respectively. Concerning morphology, 14 were diagnosed as NG and 14 as G group. The rate of malignant change was 28.6% (8/28). Twenty‐three of our patients received endoscopic treatment (5 for endoscopic piecemeal mucosal resection 18 for endoscopic submucosal dissection) and five for laparoscopy‐assisted colectomy. The cost and length of admission analysis between the endoscopic and operation treatment groups showed significant cost reduction (endoscopy/operation: NTD 28172/82516, p