Endoscopic and surgical treatment of the colonic polyps

Endoscopic surgery of the gastrointestinal tract has become in the last years one of the most important procedures in the treatment of some digestive diseases. In view of the positive results obtained by means of the diagnostic coloscopy, an extension of this modern method for therapeutic purposes has been considered appropriate. At the Digestive Endoscopy Centre of the 3rd Surgical Clinic of University of Rome, 1337 coloscopies have been carried out, of which, 1236 were routine, 86 urgent and 15 intraoperative cases. Operative coloscopy was carried out in 310 routine and 16 urgent cases. From a technical point of view, operative endoscopy in the colon is particularly difficult and requires considerable experience. It is our opinion that this method can give useful and interesting contributions to the diagnosis and therapy of some lesions of the large intestine, provided suitable surgical conditions are available with all the necessary equipment. Following these criteria, it is possible to avoid complications such as haemorrhage and intestinal perforation. Our experience in this field is undoubtedly positive, since there has not been any complication but it is necessary to perform operative coloscopy under fluoroscopic control. With regard to coloscopic polypectomy it is the opinion of the authors that this procedure has a therapeutic value in benign polyps and when superficial cancerization has not invaded the muscularis mucosae in the head of the polyp.