Tuesday, November 17, 2009

Haggitt Levels - Colonic Polyps

Describe invasion of invasive carcinoma in pedunculated colonic polyps.  The Kudo classification is used to describe invasion in sessile polyps.

Level 0 - CIS (carcinoma confined to mucosal layer)

Invasion through Lamina propria:
Level 1 - invasion into submucosa limited to head of polyp
Level 2 - invasion into submucosa extending to neck of polyp
Level 3 - invasion into submucosa extending to stalk of polyp
Level 4 - invasion beyond the stalk but above the muscularis propria

Indications for Surgical Management of Polyps after Polypectomy:
- Positive margins
- Piecemeal resection
- Lymphovascular invasion
- Poorly differentiated
- Haggit level 4
- Unable to resect endoscopically

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