Polypectomy and advanced endoscopic resection

Most colorectal cancers evolve from colorectal adenomatous polyps in a pathway known as the adenoma to carcinoma sequence. Early detection and removal of colorectal adenomas can prevent the development of colorectal cancer. The vast majority of these polyps can be resected endoscopically. Advances in endoscopic resection techniques have led to expanded indications for endoscopic polypectomy, whereby giant polyps, scarred lesions and early cancers may be cured. We will outline conventional endoscopic mucosal resection techniques as well as more complex resection methods such as endoscopic submucosal dissection, full thickness resection and the use of combined endoscopic and laparoscopic assisted approaches to resection. We will also explore the role of a virtual multidisciplinary team to aid decision-making when managing large and complex colorectal polyps. This review will provide an update on the endoscopic management of colorectal polyps and highlight exciting new developments in this ever-expanding field.