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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
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