Endoscopic resection of a mucosa at non-polypoid lesions of the large intestine

Aim of investigation. Retrospective evaluation of endoscopic resection of the large intestine mucosa for non-polypoid lesions was carried out with account for histological pattern, technique of resection, complications and relapses.

Stuff and methods. 76 non-polypoid lesions in 58 patients were removed. All patients previously underwent total colonoscopy by EC450 HL5 («Fujinon», Japan) or CF-230I («Olympus», Japan) endoscopes with preparation by fortrans (macrogoal), «Ipsen» company (France). Resection included following stages: guided chromoscopy by 0,5% indigo carmine solution, submucosal injection of fluid (1:10 000 epinephrine solution) by NM-220L needle («Olympus», Japan), erasion by SD-16U-1 or SD-17U-1 loop («Olympus», Japan).

Results. The majority of lesions – 45 (59,2%) were adenomas of 0-IIa type and were localized in right-sided regions of large intestine. Of 15 neoplasms with 0-IIс component in 9 cases dysplasia and in 3 – adenocarcinoma were revealed. At the absence of 0-IIc component (61 tumor) dysplasia was observed in 14 cases and adenocarcinoma – in one case. E n-block erasion was done in 67 (88,2%) cases, resection by several fragments – in 9 cases (11,8 %). All, but 2 tumors that have been removed in parts, were over 20 mm in size.

Conclusions. Endoscopic resection of the large intestine mucosa with pathological lesion is a safe and effective method for non-polypoid neoplasms treatment and is a method of choice for lesions less than 20 mm in size. Presence of 0-IIс focus significantly correlates to the presence of dysplasia or adenocarcinoma.

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