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In this study, patients with large (≥ 2cm) sessile adenomas who undergo piecemeal endoscopic resection are recommended to have a follow up examination in three to six months to examine the polypectomy site for residual disease. The study was a retrospective single academic center review of synchronous neoplastic findings in 190 consecutive patients with intact colons and single large sessile adenomas resected endoscopically. All included patients had at least one full colonoscopy. Synchronous polyps were those removed at the same colonoscopy that discovered the large sessile adenoma, or at any follow up endoscopic examination within 12 months of discovery of the large sessile adenoma.

Researchers found that 75 percent of patients had at least one synchronous adenoma, and the 190 patients had an average of four synchronous adenomas. Thirty percent of patients had at least one synchronous advanced adenoma (adenoma ≥1 cm in size, or with high grade dysplasia or villous element), and three percent had synchronous lesions with high-grade dysplasia. Synchronous disease was distributed throughout the colon and was likely to be in a distant colonic segment as in the same or an adjacent colonic segment. Researchers concluded that patients with large sessile adenomas resected endoscopically warrant follow up not only to ensure complete resection, but also to ensure clearing of the entire colon.

Research by Marcia I. Canto, MD, FASGE, associate professor of medicine and oncology, Johns Hopkins University, Baltimore, MD, was presented on the preoperative detection of familial pancreatic neoplasms. Lives can be saved if high grade dysplasia and early familial ductal adenocarcinoma can be detected in high risk individuals be
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