Sessile Serrated Adenomas: How to Detect, Characterize and Resect.
- Author:
Michael X MA
1
;
Michael J BOURKE
Author Information
- Publication Type:Review
- Keywords: Sessile serrated adenoma; Detection; Endoscopic imaging; Histology; Endoscopic resection
- MeSH: Adenoma*; Colorectal Neoplasms; Polyps
- From:Gut and Liver 2017;11(6):747-760
- CountryRepublic of Korea
- Language:English
- Abstract: Serrated polyps are important contributors to the burden of colorectal cancers (CRC). These lesions were once considered to have no malignant potential, but currently up to 30% of all CRC are recognized to arise from the serrated neoplasia pathway. The primary premalignant lesions are sessile serrated adenomas/polyps (SSA/Ps), although traditional serrated adenomas are relatively uncommon. Compared to conventional adenomas, SSA/Ps are morphologically subtle with indistinct borders, may be difficult to detect endoscopically, are more prevalent than previously thought, are associated with synchronous and metachronous advanced neoplasia, and have a higher risk of incomplete resection. Although many lesions remain “dormant,” progressive disease is associated with the development of dysplasia and more rapid progression to CRC. As a result, SSA/Ps are strongly implicated in the development of interval cancers. These factors represent unique challenges that require a meticulous approach to their management. In this review, we summarize the contemporary literature on the characterization, detection and resection of SSA/Ps.
