Endoscopic treatment of colorectal carcinoma

All malignant pedunculated polyps of the colon can be removed totally by colonoscopy alone. Resection of the colon is only necessary in those few instances where the cancer portion is poorly differentiated and where there are cancer cells in lymphatic or vascular channels. Malignant well differentiated sessile polyps are adequately managed by the endoscopic technique as well if the polypectomy is believed to have been complete and this can be confirmed by follow-up biopsies after 4-8 weeks. In these patients Laser therapy may also be of value. Endoscopic Laser therapy may be of value as a symptomatic treatment in patients with advanced malignant disease with obstruction or bleeding.