{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T13:06:15Z","timestamp":1773839175868,"version":"3.50.1"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:p>\n            Background\u2002Large (\u2265\u200a20\u200amm) nonpedunculated colorectal lesions have high rates of synchronous neoplasia and advanced neoplasia. Synchronous neoplasia prevalence in patients with large pedunculated lesions is uncertain. We describe synchronous neoplasia in patients with large pedunculated colorectal polyps, using a cohort of patients with large nonpedunculated lesions as controls.<\/jats:p><jats:p>\n            Methods\u2002This study was a retrospective assessment of a prospectively recorded database listing synchronous findings in patients with \u2265\u200a20\u200amm colorectal lesions referred to a tertiary center for endoscopic resection.<\/jats:p><jats:p>\n            Results\u2002At least one synchronous precancerous lesion was identified in 66\/78 patients with large pedunculated index lesions (84.6\u200a%, 95\u200a%CI 74.9\u201391.1) and 726\/814 patients with large nonpedunculated index lesions (89.2\u200a%, 95\u200a%CI 87.1\u201391.3). Patients with a large pedunculated index lesion had mean of 4.8 synchronous conventional adenomas, 56.4\u200a% had \u2265\u200a1 synchronous high risk lesion (advanced adenoma or advanced serrated lesion), 48.7\u200a% had\u200a\u2265\u200a1 synchronous advanced conventional adenoma, and 19.2\u200a% had a synchronous neoplastic lesion \u2265\u200a20\u200amm. Compared with patients with nonpedunculated index lesions, patients with large pedunculated index lesions had comparable rates of synchronous polyps, adenomas, and sessile serrated lesions, and higher rates of synchronous adenomas with villous elements (15.6\u200a% [95\u200a%CI 13.3\u201318.3] vs. 26.9\u200a% [95\u200a%CI 18.3\u201337.7]; P\u200a=\u200a0.01) and synchronous pedunculated polyps (9.5\u200a% [95\u200a%CI 7.6\u201311.7] vs. 33.3\u200a% [95\u200a%CI 23.8\u201344.4]; P\u200a&lt;\u200a0.001).<\/jats:p><jats:p>\n            Conclusion\u2002In patients with large (\u2265\u200a20\u200amm) pedunculated colorectal lesions, rates of synchronous neoplasia and advanced synchronous neoplasia were high and comparable to or higher than rates of synchronous neoplasia in patients with large nonpedunculated colorectal lesions.<\/jats:p>","DOI":"10.1055\/a-1976-4757","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T23:46:21Z","timestamp":1668123981000},"page":"537-543","source":"Crossref","is-referenced-by-count":4,"title":["Prevalence of synchronous neoplasia in patients with large pedunculated colorectal polyps"],"prefix":"10.1055","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5359-942X","authenticated-orcid":false,"given":"Ahmed","family":"El Rahyel","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology\/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel E.","family":"Lahr","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology\/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas K.","family":"Rex","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology\/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,2,6]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.gie.2016.06.035","article-title":"High yield of synchronous lesions in referred patients with large lateral spreading colorectal tumors","volume":"85","author":"B L Bick","year":"2017","journal-title":"Gastrointest Endosc"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1590\/s0004-2803.201900000-52","article-title":"Increased risk of synchronous colorectal lesions in patients referred for endoscopic mucosal resection of lateral spreading tumors","volume":"56","author":"M C Torella","year":"2019","journal-title":"Arq Gastroenterol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/j.cgh.2008.04.012","article-title":"Large sessile adenomas are associated with a high prevalence of synchronous advanced adenomas","volume":"6","author":"W Mattar","year":"2008","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1016\/j.gie.2012.01.033","article-title":"Failure to recognize serrated polyposis syndrome in a cohort with large sessile colorectal polyps","volume":"75","author":"K C Vemulapalli","year":"2012","journal-title":"Gastrointest Endosc"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1016\/j.gie.2009.05.039","article-title":"Large refractory colonic polyps: is it time to change our practice? 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