Importance of detecting stalkless polyps in patients with inflammatory bowel disease

Post by Master, Doctor Mai Vien Phuong - Department of Examination & Internal Medicine - Vinmec Central Park International General Hospital

Patients with persistent inflammatory bowel disease (IBD) have a higher risk of developing colorectal cancer than the general population. In particular, the detection of pedunculated polyps plays an important role in the treatment of patients with inflammatory bowel disease.

Random sampling is not effective in detecting areas of dysplasia, especially in the case of sessile polyps. Stained colonoscopy with targeted biopsies significantly improves surveillance efficiency (approximately 7% increase in a recent meta-analysis), whereas NBI did not show a clear superiority over colonoscopy High-definition white light in the detection of dysplasia in IBD patients.

Increased dysplastic lesions in the current or previous inflamed area are termed dysplasia-associated tumor/tumor (DALM). Until recently, dysplastic lesions indicated for resection because of the higher cancer risk were reported.
DALMs present as round, sessile, or pedunculated polyps and should be promptly and thoroughly treated with endoscopic excision (contextual biopsy should be obtained from surrounding normal-looking mucosa). polypectomy margin to detect other dysplastic areas). If a timely and appropriate endoscopic therapy is performed, the overall cancer progression rate of adenoma-like DALMs is very low (only 2.4% in a recent review).
If radical resection is not feasible, or if dysplastic foci of adjacent mucosa are detected, excision is mandatory.

Stem non-polyposis lesions may be more difficult to detect and differentiate from surrounding inflamed mucosa and require particularly careful endoscopic evaluation.
Once sessile polyps are detected, treatment is the same as the previously described approach for DALM but necessitates resection of the entire mass (when this is not possible, surgery remains the option). only).
Vinmec International General Hospital is one of the leading hospitals in the country in terms of examination, diagnosis and treatment of digestive diseases. With modern equipment, sterile space, minimizing the impact as well as the risk of disease spread. Along with that is the dedication from the doctors with professional experience with pediatric patients, making the examination no longer a concern of the parents.

References: Antonio Facciorusso et al. Non-polypoid colorectal neoplasms: Classification, therapy and follow-up. World J Gastroenterol. 2015 May 7; 21(17): 5149–5157.