[Limits of endoscopic polypectomy]

Endoscopic polypectomy has become the preferred technique for the removal of colorectal adenomas. This procedure may become difficult or impossible because of the location or the appearance (sessile versus pedunculated) of the polyps. For histopathological classification the removal of the whole lesion is necessary. There is no doubt that endoscopic polypectomy or local surgical excision is the adequate curative treatment for adenomas and "carcinomas limited to the mucosa". The local polypectomie is also an adequate treatment for "early colorectal cancer", if you define and separate a high group of patients, for whom operative endoscopy alone is not enough. Conservative therapeutic procedures such as endoscopic polypectomy require certain selection criteria regarding the cancers stage, the careful histological examination of the whole specimen and short-term controls.