TY - JOUR
T1 - Update on Difficult Polypectomy Techniques
AU - Ngamruengphong, Saowanee
AU - Pohl, Heiko
AU - Haito-Chavez, Yamile
AU - Khashab, Mouen A.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - 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.
AB - 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.
KW - Adenoma
KW - Colonic polyps
KW - Colonoscopy
KW - Endoscopic resection
KW - Polypectomy
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U2 - 10.1007/s11894-015-0476-7
DO - 10.1007/s11894-015-0476-7
M3 - Review article
C2 - 26714965
AN - SCOPUS:84952882034
VL - 18
SP - 1
EP - 11
JO - Current Gastroenterology Reports
JF - Current Gastroenterology Reports
SN - 1522-8037
IS - 1
M1 - 3
ER -