The Difficult Colorectal Polyp

Surg Clin North Am. 2017 Jun;97(3):515-527. doi: 10.1016/j.suc.2017.01.003.

Abstract

Difficult colorectal polyps represent lesions that pose a challenge to traditional endoscopic snare polypectomy. These polyps have historically been managed by surgical resection. Currently, several less invasive options are available to avoid colectomy. Repeat colonoscopy and snare polypectomy by an expert endoscopist, endoscopic mucosal resection, endoscopic submucosal dissection, and combined endoscopic and laparoscopic surgery have been developed to remove difficult polyps without the need for formal surgical resection. Patients with rectal polyps have the advantage of additional transanal minimally invasive techniques to enhance their resectability. Today, most colorectal polyps can be managed without the need for formal surgical resection.

Keywords: Colonoscopy; Colorectal polyps; Endoscopic mucosal resection; Endoscopic submucosal dissection; Laparoscopic colon surgery; Polypectomy.

Publication types

  • Review

MeSH terms

  • Colonic Polyps / pathology
  • Colonic Polyps / surgery*
  • Colonoscopy
  • Endoscopic Mucosal Resection
  • Humans
  • Laparoscopy
  • Neoplasm Invasiveness
  • Precancerous Conditions / pathology
  • Precancerous Conditions / surgery