[Colorectal adenoma: pro conventional/laparoscopic resection]

Area of Science:

• Gastroenterology
• Surgical Oncology

Context:

• Colorectal polyps have the potential to progress to invasive cancer, necessitating complete removal.
• Endoscopic polypectomy is the primary method for managing the majority of colorectal polyps.

Purpose:

• To outline the indications for surgical intervention in colorectal polyp removal.
• To discuss the role of minimally invasive surgery and transanal techniques for specific polyp presentations.

Summary:

• Surgical removal of colorectal polyps is indicated for incomplete endoscopic resection, difficult locations, or lesions highly suspicious for malignancy unresponsive to endoscopic detachment.
• Minimally invasive laparoscopic surgery is a viable option when surgical intervention is necessary.
• Transanal resection, including transanal endoscopic microsurgery (TEM), is recommended for suspicious adenomas in the lower rectum, enabling en bloc resection for accurate pathological assessment.

Impact:

• Facilitates accurate pathological staging, including depth of invasion and margin assessment.
• Guides surgical decision-making, reserving radical surgery for high-risk situations.
• Optimizes patient management by selecting the most appropriate and effective polyp removal strategy.