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Dig Liver Dis. 2015 Feb;47(2):95-102. doi: 10.1016/j.dld.2014.09.006. Epub 2014 Oct 25.

Sessile serrated adenoma: from identification to resection.

Author information

1
Department of Gastroenterology, Cochin Teaching Hospital, AP-HP, Paris, France.
2
Department of Gastroenterology, Cochin Teaching Hospital, AP-HP, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France.
3
Paris Descartes University, Sorbonne Paris Cité, Paris, France; Department of Pathology, Cochin Teaching Hospital, AP-HP, Paris, France.
4
Department of Gastroenterology, Cochin Teaching Hospital, AP-HP, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France. Electronic address: romain.coriat@cch.aphp.fr.

Abstract

Until the past two decades, almost all colorectal polyps were divided into two main groups: hyperplastic polyps and adenomas. Sessile serrated adenomas presented endoscopic, pathological and molecular profiles distinct from others polyps. Previously under-diagnosed, physicians now identified sessile serrated adenomas. The serrated neoplastic pathway is accounting for up to one-third of all sporadic colorectal cancers and sessile serrated adenomas have been identified as the main precursor lesions in serrated carcinogenesis. By analogy with the adenoma-adenocarcinoma sequence, the sessile serrated adenomas-adenocarcinoma sequence, has been identified. The development of endoscopic resection techniques permits the consideration of a non-surgical approach as the first option regardless of the size of the lesion. Sessile serrated adenoma warrants the watchfulness of physicians and requires an optimal quality of the colonoscopy procedure, a thorough evaluation of the lesion, an adequate endoscopic resection and follow-up colonoscopies in accordance with sessile serrated adenomas guidelines. We herein present a review on sessile serrated adenomas focusing on their pathological specificities, epidemiology, treatment modalities and follow-up.

KEYWORDS:

Colonoscopy; Colorectal cancer; Histology; Molecular pathology; Serrated adenoma

PMID:
25445408
DOI:
10.1016/j.dld.2014.09.006
[Indexed for MEDLINE]
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