Current Trends in the Management of a Complex Polyp: Endoscopy versus Surgery.

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Colorectal cancer often originates from adenomatous polyps or sessile serrated lesions.
• Screening guidelines and endoscopic polyp resection have reduced colorectal cancer incidence and mortality in the US.
• Polyp complexity varies by size, location, and morphology, influencing resectability.

Purpose of the Study:

• To review endoscopic resection techniques for complex colorectal polyps.
• To discuss advancements in endoscopic tools and their impact on polyp management.
• To highlight potential challenges in endoscopic polyp resection.

Main Methods:

• Review of current endoscopic resection techniques.
• Discussion of endoscopic mucosal resection (EMR).
• Discussion of endoscopic submucosal dissection (ESD) and endoscopic full-thickness resection (EFTR).

Main Results:

• Complex polyps, once requiring surgery, are increasingly resectable endoscopically.
• Advancements in endoscopic techniques and tools enhance safety and efficacy.
• EMR, ESD, and EFTR are viable options for complex polyp removal.

Conclusions:

• Endoscopic resection is a safe and effective treatment for complex colorectal polyps.
• Technological advancements have expanded the role of endoscopy in colorectal cancer prevention.
• Understanding different endoscopic techniques is crucial for optimal patient management.