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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(05): E713-E715
DOI: 10.1055/a-1373-5176
Editorial

Overutilization of surgery for the resection of benign colorectal lesions: the hidden reasons for inappropriate referral!

Mathieu Pioche
1   Hepatogastroenterology division, Edouard Herriot Hospital, Hospices civils de Lyon, France
,
Eddy Cotte
2   Department of digestive and oncological surgery, Lyon Sud Hospital, Hospices Civils de Lyon, France
,
Cesare Hassan
3   Department of gastroenterology and endoscopy, Nuovo Regina Margherita Hospital Rome, Italy
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Overutilization of surgical resection for benign colorectal polyps: analysis from a tertiary care centerEndosc Int Open 2021; 09(05): E706-E712
DOI: 10.1055/a-1380-3017

At the beginning, it was surgery! Surgery was the only pre-endoscopic technique to remove colorectal polyps detected at barium enema or proctoscopy. When endoscopic polypectomy was introduced, it was clear that most of the polyps could be removed noninvasively. In the pre-endoscopic mucosal resection (EMR) era, however, a gray area between endoscopy and surgery remained. When dealing with benign-appearing lesions, it was unofficially assumed that lesions > 4 cm or expanding in more than two consecutive folds were to be treated surgically. BIG size, BIG treatment! Such a paradigm was somewhat facilitated by the implementation of laparoscopic colorectal surgery, which was believed to minimize surgery-related morbidity, especially in the right colon.



Publication History

Article published online:
22 April 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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Letter to this article:

Patient outcomes: The only size that eventually matters in dealing with colonic neoplasiaEndosc Int Open 2021; 09(11): 1843-1844
DOI: 10.1055/a-1591-0593

 

  • References

  • 1 Ferlitsch M, Moss A, Hassan C. et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2017; 49: 270-297
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 de Neree Tot Babberich MPM, Bronzwaer MES, Andriessen JO. et al. Outcomes of surgical resections for benign colon polyps: a systematic review. Endoscopy 2019; 51: 961-972
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Le Roy F, Manfredi S, Hamonic S. et al. Frequency of and risk factors for the surgical resection of nonmalignant colorectal polyps: a population-based study. Endoscopy 2015; DOI: 10.1055/s-0034-1392976.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Saade R, Tsang T, Kmeid M. et al. Overutilization of surgical resection for benign colorectal polyps: analysis from a tertiary care center. Endosc Int Open 2021; 09: E706-E712
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Backes Y, Schwartz MP, Ter Borg F. et al. Multicentre prospective evaluation of real-time optical diagnosis of T1 colorectal cancer in large non-pedunculated colorectal polyps using narrow band imaging (the OPTICAL study). Gut 2019; 68: 271-279
    CrossrefPubMedGoogle Scholar
  • 6 Puig I, López-Cerón M, Arnau A. et al. Accuracy of the narrow-band imaging international colorectal endoscopic classification system in identification of deep invasion in colorectal polyps. Gastroenterology 2019; 156: 75-87
    CrossrefPubMedGoogle Scholar
  • 7 Fabritius M, Jacques J, Gonzalez J-M. et al. A simplified table using validated diagnostic criteria is effective to improve characterization of colorectal polyps: the CONECCT teaching program. Endosc Int Open 2019; 07: E1197-E1206
    Article in Thieme ConnectPubMedGoogle Scholar