[Large colonic polyp: endoscopic or surgical removal?]

93 neoplastic polyps measuring more than 2 cm in diameter have been removed from the colon by endoscopy. 15% of the polyps showed severe atypia (focal carcinoma), and in 15% an invasive carcinoma was found. Polypectomy was complicated in 14 cases by bleeding, in 12 cases it was cured by endoscopy. In 1 case in which the colon was injured by coagulation the lesion healed spontaneously. The surgery rate due to complications of the endoscopic removal procedure or due to invasive carcinoma was 7% for the polyps with a diameter of 2-3 cm, 15% for those of 3-5 cm and 50% for polyps with a diameter of more than 5 cm. It is therefore suggested that neoplastic polyps of more than 5 cm in diameter should be removed by endoscopy in high risk patients only.