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Advances, problems, and complications of polypectomy

The major role of colonoscopy with polypectomy in reducing the incidence of and mortality from colorectal cancer has been firmly established. Yet there is cause to be uneasy. One of the most striking recent findings is that there is an alarmingly high incomplete polyp removal rate. This phenomenon,...

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Autores principales: Anderloni, Andrea, Jovani, Manol, Hassan, Cesare, Repici, Alessandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155740/
https://www.ncbi.nlm.nih.gov/pubmed/25210470
http://dx.doi.org/10.2147/CEG.S43084
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author Anderloni, Andrea
Jovani, Manol
Hassan, Cesare
Repici, Alessandro
author_facet Anderloni, Andrea
Jovani, Manol
Hassan, Cesare
Repici, Alessandro
author_sort Anderloni, Andrea
collection PubMed
description The major role of colonoscopy with polypectomy in reducing the incidence of and mortality from colorectal cancer has been firmly established. Yet there is cause to be uneasy. One of the most striking recent findings is that there is an alarmingly high incomplete polyp removal rate. This phenomenon, together with missed polyps during screening colonoscopy, is thought to be responsible for the majority of interval cancers. Knowledge of serrated polyps needs to broaden as well, since they are quite often missed or incompletely removed. Removal of small and diminutive polyps is almost devoid of complications. Cold snare polypectomy seems to be the best approach for these lesions, with biopsy forcep removal reserved only for the tiniest of polyps. Hot snare or hot biopsy forcep removal of these lesions is no longer recommended. Endoscopic mucosal resection and endoscopic submucosal dissection have proven to be effective in the removal of large colorectal lesions, avoiding surgery in the majority of patients, with acceptably low complication rates. Variants of these approaches, as well as new hybrid techniques, are being currently tested. In this paper, we review the current status of the different approaches in removing polypoid and nonpolypoid lesions of the colon, their complications, and future directions in the prevention of colorectal cancer.
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spelling pubmed-41557402014-09-10 Advances, problems, and complications of polypectomy Anderloni, Andrea Jovani, Manol Hassan, Cesare Repici, Alessandro Clin Exp Gastroenterol Review The major role of colonoscopy with polypectomy in reducing the incidence of and mortality from colorectal cancer has been firmly established. Yet there is cause to be uneasy. One of the most striking recent findings is that there is an alarmingly high incomplete polyp removal rate. This phenomenon, together with missed polyps during screening colonoscopy, is thought to be responsible for the majority of interval cancers. Knowledge of serrated polyps needs to broaden as well, since they are quite often missed or incompletely removed. Removal of small and diminutive polyps is almost devoid of complications. Cold snare polypectomy seems to be the best approach for these lesions, with biopsy forcep removal reserved only for the tiniest of polyps. Hot snare or hot biopsy forcep removal of these lesions is no longer recommended. Endoscopic mucosal resection and endoscopic submucosal dissection have proven to be effective in the removal of large colorectal lesions, avoiding surgery in the majority of patients, with acceptably low complication rates. Variants of these approaches, as well as new hybrid techniques, are being currently tested. In this paper, we review the current status of the different approaches in removing polypoid and nonpolypoid lesions of the colon, their complications, and future directions in the prevention of colorectal cancer. Dove Medical Press 2014-08-30 /pmc/articles/PMC4155740/ /pubmed/25210470 http://dx.doi.org/10.2147/CEG.S43084 Text en © 2014 Anderloni et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Anderloni, Andrea
Jovani, Manol
Hassan, Cesare
Repici, Alessandro
Advances, problems, and complications of polypectomy
title Advances, problems, and complications of polypectomy
title_full Advances, problems, and complications of polypectomy
title_fullStr Advances, problems, and complications of polypectomy
title_full_unstemmed Advances, problems, and complications of polypectomy
title_short Advances, problems, and complications of polypectomy
title_sort advances, problems, and complications of polypectomy
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155740/
https://www.ncbi.nlm.nih.gov/pubmed/25210470
http://dx.doi.org/10.2147/CEG.S43084
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