Flat XXXX in Malaysia: fact or fancy?

@entity1 @entity308 @entity5115 @entity1127 @entity55433 @entity75 @entity5 @entity189 @entity6693 @entity6523 @entity14 @entity652 @entity1586
BACKGROUND: Some two-thirds of @entity14 arise from @entity6523 , and as such, screening by colonoscopy and polyp removal should significantly reduce @entity14 . This has not been the case, as evidenced by recent studies, which revealed that endoscopy failed to prevent up to 50% of all subsequent @entity189 . Flat or depressed @entity652 , frequently reported from Japan but rarely elsewhere, might explain the 'missed @entity189 .' Detection of flat @entity652 has not been previously reported from Malaysia. METHODS: In the present prospective study, 426 consecutive @entity1 underwent colonoscopic examination between March 1997 and January 2000, for a variety of bowel symptoms. The examinations were performed by an experienced endoscopist using a standard colonoscope and @entity6693 dye spraying technique. Macroscopically, flat @entity652 were defined using the criteria proposed by Sawada. RESULTS: Twenty-nine @entity652 were identified in 12 @entity1 , of which 15 were polypoid and 14 were flat, with no @entity308 . Eight @entity75 and all the flat @entity652 contained mild or moderate areas of @entity5115 . Seven severely @entity1127 were identified. One @entity5 and two advanced @entity189 were also found. All the severely @entity5 were found in @entity1127 greater than 10 mm in mean size. The flat @entity652 were all less than 5 mm in size. CONCLUSIONS: A significant proportion of @entity1586 in @entity55433 @entity1 appear as small flat lesions, which could easily be missed during endoscopy. Increased recognition and treatment of flat @entity652 among colonoscopists is warranted.
