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What Are the Options for Management of Large Colonic Polyps?

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Difficult Decisions in Colorectal Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

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Abstract

Colorectal cancer is the third most commonly diagnosed cancer and second leading cause of cancer-related mortality globally [1, 2]. Based on adenoma-carcinoma sequence theory, early detection and removal of colorectal neoplasms is essential for improving cancer incidence and mortality [3]. Ideally, a neoplastic lesion should be resected in one-piece (en-bloc) with histologically negative margins (R0). Fortunately, 80–90% of polyps are ≤1 cm and can effectively be managed by conventional polypectomy [4]. However, management of large colorectal polyps (≥2 cm) require more advanced resection techniques, as conventional snare-based techniques might result in piecemeal resection, which precludes proper histopathological evaluation and increases the risk for recurrence [5]. Given that large polyps may have an increased risk for harboring malignancy [6], adequate treatment is of the utmost importance. Further, risks of different procedures should be considered.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland, OH, USA

    Sumeyye Yilmaz & Emre Gorgun

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  1. Sumeyye Yilmaz
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  2. Emre Gorgun
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Correspondence to Emre Gorgun .

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  1. Medical Center, University of Chicago, Chicago, IL, USA

    Konstantin Umanskiy

  2. Medical Center, University of Chicago, Chicago, IL, USA

    Neil Hyman

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Yilmaz, S., Gorgun, E. (2023). What Are the Options for Management of Large Colonic Polyps?. In: Umanskiy, K., Hyman, N. (eds) Difficult Decisions in Colorectal Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-031-42303-1_15

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  • DOI: https://doi.org/10.1007/978-3-031-42303-1_15

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