大腸脂肪腫23例の臨床的検討

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  • A CLINICAL ANALYSIS OF COLONIC LIPOMA IN 23 CASES

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The outcomes and clinicopathological features of 23 patients with 25 lesions of colonic lipoma treated in the period from 1980 to 1990 were analyzed. Lipomas were more commonly found in middle-aged or elderly patients, in females and on the right side of the colon. Twenty lesions (80%) were 3cm or less in diameter and sessile polyps. Twenty-four lesions (96%) were located in the submucosal layer and 21 lesions (84%) had a smooth surface. In symptomatic cases, smaller lipomas were observed to have bleeding, while greater lipomas were observed to have abdominal pain, change in bowel habits, and intussusception. The correct pretreatment diagnosing rate of lipomas was only 26%. Colectomy was performed for 14 lesions and endoscopic polypectomy was performed for 11 lesions. Endoscopic polypectomy was performed for colonic lipomas with a diameter of 2.5cm or less (mean: 1.3cm), while colectomy was performed for lesions with a diameter of more than 2.6cm. Endoscopic polypectomy cases had no complications. In conclusion, patients who have colonic lipomas with a diameter of 2.5cm or less should be recommended to underwent endoscopic polypectomy, though we should consider resection to the symptomatic cases, cases of difficulty in distinguishing from malignancy, and those with a tendency to grow in size.

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