Optimizing detection and resection of colorectal polyps

Area of Science:

• Gastroenterology
• Endoscopy
• Surgical Oncology

Background:

• Colonoscopy is the primary screening tool for colorectal cancer (CRC) prevention in the US.
• Effective CRC screening relies on accurate polyp detection, histology prediction, and safe removal.
• Optimizing colonoscopy requires advancements in detection and resection techniques.

Purpose of the Study:

• To comprehensively review current evidence on tools and techniques for improving polyp detection during colonoscopy.
• To summarize best practices for optimizing endoscopic polyp removal.
• To discuss adverse events and preventative measures associated with polypectomy.

Main Methods:

• Review of current evidence on advanced colonoscopy tools and techniques.
• Summary of modifications in endoscopic mucosal resection (EMR) and endoscopic full-thickness resection (EFTR).
• Analysis of common adverse events and preventative strategies.

Main Results:

• Water-assisted colonoscopy, AI, IEE, and distal attachments enhance polyp detection.
• Underwater EMR shows promise over conventional EMR; modified EMR techniques are summarized.
• EFTR is an emerging option for early submucosal cancers; adverse events like bleeding and perforation are discussed.

Conclusions:

• Technological advancements and refined techniques are crucial for improving colonoscopy efficacy in CRC prevention.
• Focus on reducing interval CRC and improving safety will drive adoption of new methods.
• Optimized polyp detection and resection are key to reducing CRC incidence and mortality.