Management of complex polyps of the colon and rectum

doi:10.1007/s00384-017-2950-1

Review

. 2018 Feb;33(2):115-129.

doi: 10.1007/s00384-017-2950-1. Epub 2017 Dec 28.

Management of complex polyps of the colon and rectum

Fernando A Angarita¹, Adina E Feinberg¹, Stanley M Feinberg^{1

2}, Robert H Riddell^{3

4}, J Andrea McCart^{5

6

7}

Affiliations

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.

PMID: 29282496
DOI: 10.1007/s00384-017-2950-1

Review

Management of complex polyps of the colon and rectum

Fernando A Angarita et al. Int J Colorectal Dis. 2018 Feb.

. 2018 Feb;33(2):115-129.

doi: 10.1007/s00384-017-2950-1. Epub 2017 Dec 28.

Authors

Fernando A Angarita¹, Adina E Feinberg¹, Stanley M Feinberg^{1

2}, Robert H Riddell^{3

4}, J Andrea McCart^{5

6

7}

Affiliations

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.

PMID: 29282496
DOI: 10.1007/s00384-017-2950-1

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.

Keywords: Colonic polyps; Colorectal polyps; Endoscopic mucosal resection; Endoscopy; Surgery.

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References

1. Am J Surg. 1987 Jan;153(1):41-7 - PubMed
1. Dis Colon Rectum. 2003 Mar;46(3):340-8 - PubMed
1. Gastrointest Endosc. 2016 Jun;83(6):1299 - PubMed
1. Endoscopy. 2003 Oct;35(10):845-9 - PubMed
1. Gut. 2006 Nov;55(11):1592-7 - PubMed

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[1] Am J Surg. 1987 Jan;153(1):41-7 - PubMed

[2] Am J Surg. 1987 Jan;153(1):41-7 - PubMed

[3] Dis Colon Rectum. 2003 Mar;46(3):340-8 - PubMed

[4] Dis Colon Rectum. 2003 Mar;46(3):340-8 - PubMed

[5] Gastrointest Endosc. 2016 Jun;83(6):1299 - PubMed

[6] Gastrointest Endosc. 2016 Jun;83(6):1299 - PubMed

[7] Endoscopy. 2003 Oct;35(10):845-9 - PubMed

[8] Endoscopy. 2003 Oct;35(10):845-9 - PubMed

[9] Gut. 2006 Nov;55(11):1592-7 - PubMed

[10] Gut. 2006 Nov;55(11):1592-7 - PubMed

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Management of complex polyps of the colon and rectum

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Management of complex polyps of the colon and rectum

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