Cancerous colonic polyps. "Hands on" or "hands off?"

Management of the malignant colonic polyp remains a subject for debate even after almost two decades of experience. Some researchers believe all patients should have a colonic resection; others argue that only certain cases call for laparotomy, while still others hold for a selective approach but with varying criteria. Therefore, a survey has been made of current practice and opinion from the time colonoscopic polypectomy was introduced in 1969 to the present. The authors have reviewed a sizable segment of their experience, dividing cases of malignant polyps into two broad categories: those in which complete polypectomy was followed by bowel resection; and those undergoing polypectomy alone. The determinants leading to one course or the other were analyzed, as were the results.