Open Access

The concept of ‘Semi‑clean colon’ using the pit pattern classification system has the potential to be acceptable in combination with a <3‑year surveillance colonoscopy

  • Authors:
    • Yasuharu Maeda
    • Shin‑Ei Kudo
    • Kunihiko Wakamura
    • Hideyuki Miyachi
    • Masashi Misawa
    • Yuichi Mori
    • Noriyuki Ogata
    • Toyoki Kudo
    • Kenta Kodama
    • Tomokazu Hisayuki
    • Takemasa Hayashi
    • Atsushi Katagiri
    • Fumio Ishida
  • View Affiliations

  • Published online on: June 29, 2017     https://doi.org/10.3892/ol.2017.6491
  • Pages: 2735-2742
  • Copyright: © Maeda et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Histological features of colorectal lesions are currently evaluated via a magnifying chromoendoscopy [pit pattern (PIT) classification]. Advanced histological features are rarely observed in diminutive (≤5 mm) adenomatous polyps (DAPs). The Japanese guidelines indicate that diminutive neoplastic lesions without carcinomatous findings may be left untreated and followed up. At the present institution, DAPs with type IIIL PIT are left untreated in various cases, whereas lesions with type III, IV or V PIT are typically resected via routine colonoscopy. This retrospective study aimed to assess the management of DAPs using PIT classification. The participants of the study included patients <30 years previously referred for an initial colonoscopy, then reobserved for <3 years following the procedure. Participants were classified into three groups: Group A, Patients with type IIIL PIT DAP left untreated (semi‑clean colon group); group B, patients with all neoplastic polyps, including DAPs, resected (clean colon group); and group C, patients without any adenomatous polyps (internal control group). The cumulative incidence of the index lesions (ILs) at the follow‑up colonoscopy was analysed among the three groups. A total of 4,313 patients were enrolled in the study, with categorization as follows: Group A, 1,246; group B, 1,205; and group C, 1,862 patients. ILs were detected in group A, 100 (8.0%); group B, 104 (8.6%); and group C, 29 (1.6%) patients. There was no significant difference observed between groups A and B. It was verified that removing the type IIIL PIT DAPs did not decrease the incidence of ILs within a 3‑year time period. Therefore, these polyps may be left untreated in combination with patient reobservation at an appropriate time interval, potentially one equal to that suggested following a polypectomy.
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September-2017
Volume 14 Issue 3

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Maeda Y, Kudo SE, Wakamura K, Miyachi H, Misawa M, Mori Y, Ogata N, Kudo T, Kodama K, Hisayuki T, Hisayuki T, et al: The concept of ‘Semi‑clean colon’ using the pit pattern classification system has the potential to be acceptable in combination with a <3‑year surveillance colonoscopy. Oncol Lett 14: 2735-2742, 2017
APA
Maeda, Y., Kudo, S., Wakamura, K., Miyachi, H., Misawa, M., Mori, Y. ... Ishida, F. (2017). The concept of ‘Semi‑clean colon’ using the pit pattern classification system has the potential to be acceptable in combination with a <3‑year surveillance colonoscopy. Oncology Letters, 14, 2735-2742. https://doi.org/10.3892/ol.2017.6491
MLA
Maeda, Y., Kudo, S., Wakamura, K., Miyachi, H., Misawa, M., Mori, Y., Ogata, N., Kudo, T., Kodama, K., Hisayuki, T., Hayashi, T., Katagiri, A., Ishida, F."The concept of ‘Semi‑clean colon’ using the pit pattern classification system has the potential to be acceptable in combination with a <3‑year surveillance colonoscopy". Oncology Letters 14.3 (2017): 2735-2742.
Chicago
Maeda, Y., Kudo, S., Wakamura, K., Miyachi, H., Misawa, M., Mori, Y., Ogata, N., Kudo, T., Kodama, K., Hisayuki, T., Hayashi, T., Katagiri, A., Ishida, F."The concept of ‘Semi‑clean colon’ using the pit pattern classification system has the potential to be acceptable in combination with a <3‑year surveillance colonoscopy". Oncology Letters 14, no. 3 (2017): 2735-2742. https://doi.org/10.3892/ol.2017.6491