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Curr Gastroenterol Rep. 2016 Jan;18(1):3. doi: 10.1007/s11894-015-0476-7.

Update on Difficult Polypectomy Techniques.

Author information

1
Division of Gastroenterology and Hepatology, Department of Medicine, The Johns Hopkins Medical Institutions, 1800 Orleans Street, Zayed Bldg, Suite 7125B, Baltimore, MD, 21287, USA.
2
Department of Gastroenterology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
3
Department of Gastroenterology, VA Medical Center White River Junction, White River Junction, VT, USA.
4
Division of Gastroenterology and Hepatology, Department of Medicine, The Johns Hopkins Medical Institutions, 1800 Orleans Street, Zayed Bldg, Suite 7125B, Baltimore, MD, 21287, USA. mkhasha1@jhmi.edu.

Abstract

Endoscopists often encounter colon polyps that are technically difficult to resect. These lesions traditionally were managed surgically, with significant potential morbidity and mortality. Recent advances in endoscopic techniques and instruments have allowed endoscopists to safely and effectively remove colorectal lesions with high technical and clinical success and potentially avoid invasive surgery. Endoscopic mucosal resection (EMR) has gained acceptance as the first-line therapy for large colorectal lesions. Endoscopic submucosal dissection (ESD) has been reported to be associated with higher rate of en bloc resection and less risk of short-time recurrence, but with an increased risk of adverse events. Therefore, the role of colorectal ESD should be restricted to lesions with high-risk morphologic features of submucosal invasion. In this article, we review the recent literature on the endoscopic management of difficult colorectal neoplasms.

KEYWORDS:

Adenoma; Colonic polyps; Colonoscopy; Endoscopic resection; Polypectomy

PMID:
26714965
DOI:
10.1007/s11894-015-0476-7
[Indexed for MEDLINE]

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