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Advanced endoscopic polyp removal can prevent colorectal cancer deaths. Complex polyps, often surgically resected, could be managed endoscopically by expert panels, reducing surgery risks.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Public Health

Background:

  • Colorectal cancer (CRC) often originates from benign polyps.
  • Endoscopic polyp removal significantly decreases CRC mortality.
  • Complex polyps unsuitable for standard endoscopic removal may require surgical resection, carrying higher risks.

Purpose of the Study:

  • To evaluate the role of advanced endoscopic techniques for complex colorectal polyps.
  • To address the increasing trend of surgical resections for benign polyps in the Netherlands.
  • To propose a model for improving care and reducing unnecessary surgeries for complex polyps.

Main Methods:

  • Review of advanced endoscopic techniques for complex polyp management.
  • Analysis of trends in surgical versus endoscopic polyp resection in the Netherlands.
  • Proposal for the implementation of regional multidisciplinary expert panels.

Main Results:

  • Advanced endoscopic techniques are available for complex benign polyps.
  • Surgical resection of benign polyps is increasing in the Netherlands, potentially due to population screening.
  • Referral rates to expert centers for advanced endoscopic resection of complex polyps remain low.

Conclusions:

  • Regional multidisciplinary expert panels could enhance care quality for complex colorectal polyps.
  • Such panels may help reduce the number of surgically resected benign polyps.
  • Improved referral pathways to expert centers are needed for optimal patient management.