Abstract I years, more precise histologic diagnosis of polypoid lesions of the rectocolon and understanding of their biologic characteristics has produced a more conservative approach to these lesions above the reach of the sigmoidoscope. Even the economic practicality of routine proctosigmoidoscopy has been questioned. Furthermore the relationship of the adenomatous polyp to colonic carcinoma is not well defined, and the place of the mucosal tag in the adenomacancer complex is even less well understood. So it seems relevant, at the present time, to review the significance and treatment of all polyps found by routine proctosigmoidoscopy. The following study surveys the experience of one physician with mucosal lesions discovered on routine proctologic examination during a six-year period. Size, distribution, multiplicity, treatment, and follow-up of all polyps visualized are contrasted according to their histologic classification. Significantly, the mucosal tag is seen to have the same value as that of an adenomatous polyp in References 1. Schor, S.S., et al: An Evaluation of the Periodic Health Examination: A Study of Factors Discriminating Between Survival and Death From Coronary Heart Disease , Ann Intern Med 61:1006-1014 ( (Dec) ) 1964.Crossref 2. " Polypoid Lesions of the Gastrointestinal Tract ," in Welch, C. E. (ed.): Major Problems in Clinical Surgery , Philadelphia: W. B. Saunders Company, 1964, vol 2, pp 1-81. 3. David, V.C.: Some Etiologic and Pathologic Factors in Cancer of the Large Bowel , Arch Surg 41:257-286 ( (Aug) ) 1940.Crossref 4. Koppel, M., et al: Incidence of Cancer in the Colon and Rectum Among Polyp-Free Patients , Dis Colon Rectum 5:349-355 ( (Sept-Oct) ) 1962.Crossref 5. Spratt, J.S.; Ackerman, L.V.; and Moyer, C.A.: Relationship of Polyps of the Colon to Colonic Cancer , Ann Surg 148:682-698 ( (Oct) ) 1958.Crossref 6. Grinnel, R.S., and Lane, N.: Benign and Malignant Adenomatous Polyps and Papillary Adenomas of the Colon and Rectum: An Analysis of 1,856 Tumors in 1,335 Patients , Int Abstr Surg 106:519-538 ( (June) ) 1958. 7. Goldgraber, M.B., and Kirsner, J.B.: Polyps and Carcinoma of the Colon , Arch Intern Med 100:669-677 ( (Oct) ) 1957.Crossref 8. Knoernschild, H.E.: Growth Rate and Malignant Potential of Colonic Polyps: Early Results , Surg Forum 14:137-138, 1963. 9. Helwig, E.B.: The Evolution of Adenomas of the Large Intestine and Their Relation to Carcinoma , Surg Gynec Obstet 84:36-49 ( (Jan) ) 1947. 10. Enterline, H.T., et al: Malignant Potential of Adenomas of Colon and Rectum , JAMA 179:322-330 ( (Feb 3) ) 1962.Crossref 11. Manheimer, L.H.: Metastasis to the Liver From a Colonic Polyp: Report of a Case. New Eng J Med 272:144-145 ( (Jan 21) ) 1965.Crossref 12. Wattenberg, L.W.: A Histochemical Study of Succinic Dehydrogenase and Cytochrome Oxidase in Proliferative Lesions of the Large Intestine , Cancer Res 19:1118-1123 ( (Nov) ) 1959. 13. Enquist, I.F.: The Incidence and Significance of Polyps of the Colon and Rectum , Surgery 42:681-688 ( (Oct) ) 1957. 14. Kirsner, J.B., et al.: Polyps of the Colon and Rectum: Statistical Analysis of a Long Term Follow-Up Study , Gastroenterology 39:178-182 ( (Aug) ) 1960. 15. Weingarten, M.I., and Turrell, R.: Carcinomatous Mucosal Excrecence of the Rectum , JAMA 149:1467-1468 ( (Aug 16) ) 1952.Crossref 16. Crocker, D.W., and Veith, F.J.: Focal Primary Mucosal Hyperplasia of the Colon: The Case for Its Importance in the Pathogenesis of Cancer , Ann Surg 160:215-225 ( (Aug) ) 1964.Crossref 17. Diamond, M.: Adenomas of the Rectum and the Sigmoid in Alcoholics: A Sigmoidoscopic Study , Amer J Dig Dis 19:47-50 ( (Feb) ) 1952.Crossref 18. Stevenson, C.A., and Wilson, McC: Indications for the Double Contrast Colon Examination , Amer J Roentgen 71:398-403 ( (March) ) 1954.
Archives of Internal Medicine – American Medical Association
Published: May 1, 1967