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Clin Colon Rectal Surg
DOI: 10.1055/s-0044-1787892
Review Article

Current Trends in the Management of a Complex Polyp: Endoscopy versus Surgery

Mahnoor Khan
1   Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai South Nassau, Oceanside, New York
,
Kavel Visrodia
2   Division of Digestive and Liver Disease, Columbia University Medical Center, New York Presbyterian Hospital, New York, New York
,
Amrita Sethi
2   Division of Digestive and Liver Disease, Columbia University Medical Center, New York Presbyterian Hospital, New York, New York
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Abstract

Many colorectal cancers arise from either adenomatous polyps or sessile serrated lesions. However, due to the implementation of screening guidelines at the age of 45 years and the ability to perform therapeutic endoscopic polyp resections, the incidence and mortality of colorectal cancer has been decreasing in the United States. Polyps can be distinguished not only by pathology, but characterized by their complexity depending on the size, location, and morphology. Historically, polyps that were endoscopically more challenging to resect were referred for surgical resection. However, due to rapid advancement in endoscopic techniques and availability of tools, many of these complex polyps can be safely and effectively resected endoscopically. In this section, we review the different methods and potential challenges associated with endoscopic resection techniques including endoscopic mucosal resection, endoscopic submucosal dissection, or endoscopic full-thickness resection of a complex polyp.

Keywords

complex polypectomy - EMR - ESD - EFTR - United States


Publication History

Article published online:
03 July 2024

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