Management of complex polyps of the colon and rectum

Abstract

Puprpose

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.

Methods

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

Results

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.

Conclusion

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.

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Acknowledgements

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

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Angarita, F.A., Feinberg, A.E., Feinberg, S.M. et al. Management of complex polyps of the colon and rectum. Int J Colorectal Dis 33, 115–129 (2018). https://doi.org/10.1007/s00384-017-2950-1

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Keywords

  • Colonic polyps
  • Colorectal polyps
  • Endoscopy
  • Endoscopic mucosal resection
  • Surgery