Fernando A Angarita1, Adina E Feinberg1, Stanley M Feinberg1,2, Robert H Riddell3,4, J Andrea McCart5,6,7. 1. Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada. 2. Division of General Surgery, North York General Hospital, Toronto, ON, Canada. 3. Departments of Pathobiology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada. 4. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada. 5. Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada. amccart@mtsinai.on.ca. 6. Department of Surgery, Mount Sinai Hospital, 600 University Avenue, Suite 1225, Toronto, ON, M5G 1X5, Canada. amccart@mtsinai.on.ca. 7. Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada. amccart@mtsinai.on.ca.
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.
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.
Entities:
Keywords:
Colonic polyps; Colorectal polyps; Endoscopic mucosal resection; Endoscopy; Surgery
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