International Journal of Colorectal Disease

, Volume 33, Issue 2, pp 115–129 | Cite as

Management of complex polyps of the colon and rectum

  • Fernando A. Angarita
  • Adina E. Feinberg
  • Stanley M. Feinberg
  • Robert H. Riddell
  • J. Andrea McCart



Benign polyps that are technically challenging and unsafe to remove via polypectomy are known as complex polyps. Concerns regarding safety and completeness of resection dictate they undergo advanced endoscopic techniques, such as endoscopic mucosal resection or surgery. We provide a comprehensive overview of complex polyps and current treatment options.


A review of the English literature was conducted to identifyarticles describing the management of complex polyps of the colon and rectum.


Endoscopic mucosal resection is the standard of care for the majority of complex polyps. Only polyps that fail endoscopic mucosal resection or are highly suspicious of invasive cancer but which cannot be removed endoscopically warrant surgery.


Several factors influence the treatment of a complex polyp; therefore, there cannot be a “one-size-fitsall” approach. Treatment should be tailored to the lesion’s characteristics, the risk of adverse events, and the resources available to the treating physician.


Colonic polyps Colorectal polyps Endoscopy Endoscopic mucosal resection Surgery 



The authors would like to thank Dr. Paul Kortan (St. Michael’s Hospital, Toronto, ON, Canada) for providing feedback on this manuscript.

Supplementary material

384_2017_2950_MOESM1_ESM.pdf (129 kb)
ESM 1 (PDF 129 kb).


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Division of General Surgery, Department of SurgeryUniversity of TorontoTorontoCanada
  2. 2.Division of General Surgery, North York General HospitalTorontoCanada
  3. 3.Departments of Pathobiology and Laboratory MedicineMount Sinai HospitalTorontoCanada
  4. 4.Department of Laboratory Medicine and PathobiologyUniversity of TorontoTorontoCanada
  5. 5.Department of SurgeryMount Sinai HospitalTorontoCanada
  6. 6.Department of Surgical Oncology, Princess Margaret Cancer CentreUniversity Health NetworkTorontoCanada

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