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Veselov V.V.
Federal state budgetary institution «State Research Coloproctological Centre», Russian Ministry of Health
Serrated lesions of the colon
Journal: Russian Journal of Evidence-Based Gastroenterology. 2016;5(4): 27‑35
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To cite this article:
Veselov VV. Serrated lesions of the colon. Russian Journal of Evidence-Based Gastroenterology.
2016;5(4):27‑35. (In Russ.)
https://doi.org/10.17116/dokgastro20165427-35
Aim. The objective of the present review article was to estimate the possibilities for endoscopic diagnostics of serrated adenomas of the colon including differential diagnostics between these lesions, hyperplastic polyps, and flat adenomatous structures based on the data in the available literature publications. Materials and methods. The critical evaluation of the published information concerning epidemiology, carcinogenesis, detection and identification, differential diagnostics, as well as the methods for the surgical treatment of serrated adenomas of the colon has been undertaken. We looked through 48 relevant literature sources found in the domestic and foreign periodicals. Results. The serrated lesions of the colon are categorized into the following groups: hyperplastic polyps, «sessile» serrated adenomas associated and not associated with epithelial dysplasia, conventional serrated adenomas. Their prevalence in the general population varies, according to different authors, from 0.6% to 1.8% whereas the foci of severe dysplasia or intramucosal cancer occur inside «sessile» neoplasms at a frequency from 4% to 37%, while serrated adenocarcinomas account for almost 7.5% of all colorectal cancers. The leading role in diagnostics of serrated lesions of the colon is assigned to high-definition videocolonoscopy that enables the surgeons to detect these structures during both the routine endoscopic examination in the white light, under optical magnification, and the in the narrow light spectrum. «Sessile» serrated neoplasms serve as precursors of colonic cancer and need to be extirpated unlike the hyperplastic polyps resembling them that do not necessarily undergo malignization and are therefore subject to dynamic observation. The main characteristic features of serrated adenomas include a mucous «cap» at their surface, the type II-O structure of the epithelial pits (as described by T. Kimura), and the type I capillary network (see Sano et al.). The main method for the treatment of «sessile» serrated adenomas is endoscopic intraluminal electrical resection of the intestinal mucosa together with the tumour. Conclusion. «Sessile» serrated neoplasms of the colon are the objects of comprehensive clinical investigations by virtue of their pronounced tendency toward malignant transformation; thus far, they remain poorly studied.
Authors:
Veselov V.V.
Federal state budgetary institution «State Research Coloproctological Centre», Russian Ministry of Health
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