|International Session (Symposium)9 (JGES・JSGE・JSGS)|
|Sat. October 14th 14:40 - 17:00 Room 11: Fukuoka International Congress Center 502+503|
|Current state of surveillance colonoscopy and endoscopic treatment in patients with UC|
|M. Matsushita1, O. Watanabe1, H. Goto2|
|1Gastroenterology and Hepatology, Nagoya University Hospital, 2Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine|
|Background: Patients with ulcerative colitis (UC) have an increased risk of colorectal cancer. In our hospital, annual surveillance colonoscopy is recommended for patients with >7 years disease duration.
Aim: To elucidate the present endoscopic management and treatment of patients with UC.
Method: We conducted a retrospective evaluation of colonoscopies in patients with UC from April 2005 to March 2017. Detected lesions were classified into five pathological groups: sporadic adenoma (SA), sporadic colorectal cancer (SC), low or high grade dysplasia (LGD or HGD), and colitis-associated colorectal cancer (CC). Clinical features, endoscopic findings, and management were examined.
Results: In total, 1218 colonoscopies were performed in 452 patients with UC: SA was detected in 34 patients and removed by EMR (32) and partial colectomy (2) ; SC detected and treated in 5 patients (4, ESD; 1, partial colectomy) ; LGD in 4 patients, with intensive follow-up; ESD was attempted in 1 patient, resulting in surgery due to severe fibrosis; and HGD and CC in 6 and 27 patients, respectively; they underwent a total colectomy (except 1 patient with stage IV CC). Except for referral patients, almost all outpatients who followed-up received successful treatment (4, HGD; 4/3/1/4, stage 0/I/II/IIIa CC).
Conclusion: Surveillance colonoscopy in patients with UC is successful for detection; however, further endoscopic challenges should be explored to achieve less invasive treatment.
Index Term 1: ulcerative colitis
Index Term 2: colonoscopy