Flat polyp found in the ascending colon of an elderly patient with anaemia
WHAT DO YOU THINK TO THE LIFT?
■ Good - Attack!
Hmm, you are an optimist here!
■ Borderline - proceed with caution !
Yes, or bail out unless you are sure of what you are doing !
■ Poor - Abort !
There is no shame in bringing this back to the Cancer group to think again!
Histology confirmed that the centre was a poorly differentiated cancer which was 'probably completely removed but only with a <100 micron clear deep margin. As I keep saying, don't expect there to be "entirely good news" after an endoscopic resection of a colonic cancer.
So what happened? In spite of the original surgical misgivings the 80 year old patient subsequently underwent a right hemicolectomy which did confirm that the lesion had been completely removed by the earlier ESD. Would a full thickness resection had made any difference? Of course not! The centre of that cancer would still have been poorly differentiated!!!