Surgical management and outcome of XXXX in a university hospital.

@entity1 @entity548 @entity5 @entity3 @entity4303
BACKGROUND: @entity4303 are an uncommon entity comprising only 1%-2% of all @entity5 . @entity4303 are frequently diagnosed during colonoscopy, but management after polypectomy is still controversial. The aims of this study were to review the surgical procedures for @entity4303 and to compare the outcomes of @entity1 after different treatment modalities in a university hospital in Hong Kong. METHODS: All @entity4303 diagnosed between January 2003 and September 2012 were reviewed retrospectively, including clinicopathological characteristics, their management, and surgical outcomes. RESULTS: There were 54 @entity1 with a median age of 60  years, and 32 were males (59.3%). All @entity1 underwent colonoscopy, and the most had @entity548 (53.7%). Two @entity1 were diagnosed incidentally in the surgical specimens of rectal tissues. Eighteen @entity1 were diagnosed to have @entity4303 after snaring polypectomy, and no further intervention was required. Twenty-five @entity1 had local resection either by means of transanal resection or transanal endoscopic operation. Radical resection was performed in seven @entity1 in which one had T3N1 disease and the others did not have any lymph node @entity3 . In the median follow-up of 30  months (10-108 months), there was no recurrence in the "incidental" or post-polypectomy group. However, two @entity1 with transanal resection and two @entity1 with radical resection developed hepatic metastases after 13-24 months post-treatment. The 5-year overall survival was 100% in @entity1 having snaring polypectomy only, 83% for those with local resection, and 63% in @entity1 who underwent radical surgery (p   =   0.04). CONCLUSIONS: Our data suggested that that local resection was an effective treatment for @entity4303 and generally brought about good oncological and surgical outcomes. For larger @entity5 , radical resection seemed to provide acceptable oncological outcomes. Regular surveillance with colonoscopy and endorectal ultrasound is highly recommended for high-risk @entity1 for long-term management. By sharing our experience, we hope to provide more evidence on the management on @entity4303 which, together with evidence from further studies, may guide us in the long-term management of these @entity1 in the future.
