Kenichi Segawa

Study on Small Colorectal Polyps and Early Cancers

Abstract: We investigated the histopathological features of polyps with a diameter of less than 5 mm that had been resected by a snare or hot‐biopsy (1, 357 lesions in 712 patients), and considered the problems associated with these techniques. 67.7% of the polyps were adenomas, 15.5% were metaplastic polyps, 0.6% were colon cancers, and 0.1% were carcinoids. Eighty percent of the polyps situated on the oral side of the descending colon were adenomas. Although adenomas occurred somewhat more frequently in the sigmoid colon, they tended to be distributed evenly throughout the entire colon. The reddened color of the surface of the polyps tended to accompany adenomas, while a whitish surface color was frequently associated with metaplastic polyps. Multiple polyps occurred in 57% of the patients and 33.7% of the patients had a large polyp with a diameter of more than 6 mm. In six out of eight cases of cancer the cancers were limited to the mucosa (m), the other 2 were submucosal invaded carcinomas. One of these cases was a depressd type of cancer and the other lesions were classified as being elevated type polyps. The elevated type of diminutive early colorectal carcinoma with a diameter of less than 5 mm was difficult to distinguish endoscopically from benign polyps, so we recommended that small colonic polyps should be removed when encountered during a colonoscopy.

Clinical and Endoscopic Study of Ischemic Colitis

The clinical signs and symptoms of ischemic colitis have been analyzed. Eighty‐one cases were investigated; there were 62 cases of the transient type, 15 of the stricturing type, and 4 cases of the gangrenous type. All cases were diagnosed by colonoscopy.