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Review
. 2024 Jul 7;30(25):3126-3131.
doi: 10.3748/wjg.v30.i25.3126.

Large non-pedunculated colorectal polyp management: The elephant in the room

Shirley X Jiang  1 , Neal Shahidi  2
Affiliations
Review

Large non-pedunculated colorectal polyp management: The elephant in the room

Shirley X Jiang et al. World J Gastroenterol. .

Abstract

Minimally invasive innovations have transformed coloproctology. Specific to colorectal cancer (CRC), there has been a shift towards less invasive surgical techniques and use of endoscopic resection as an alternative for low risk T1 CRC. The role of endoscopic resection is however much more extensive: It is now considered the first line management strategy for most large (≥ 20 mm) non-pedunculated colorectal polyps, the majority of which are benign. This is due to the well-established efficacy, safety, and cost-effectiveness of endoscopic techniques compared to surgery. Multiple endoscopic modalities now exist with distinct risk-benefit profiles and their outcomes are further improved by site-specific technical modifications, auxiliary techniques, and adverse event mitigation strategies. Endoscopic capacity continues to evolve with emerging endoscopic techniques and expanding applications, particularly in the confines of a multi-disciplinary setting.

Keywords: Cancer; Colonoscopy; Endoscopic mucosal resection; Endoscopic submucosal dissection; Endoscopy; Polyp.

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Conflict of interest statement

Conflict-of-interest statement: Neal Shahidi received a speaker's honorarium from Pharmacology, Boston Scientific. Shirley X Jiang did not report a conflict of interest.

References

    1. Kuhry E, Schwenk WF, Gaupset R, Romild U, Bonjer HJ. Long-term results of laparoscopic colorectal cancer resection. Cochrane Database Syst Rev. 2008;2008:CD003432. - PMC - PubMed
    1. Juo YY, Hyder O, Haider AH, Camp M, Lidor A, Ahuja N. Is minimally invasive colon resection better than traditional approaches? First comprehensive national examination with propensity score matching. JAMA Surg. 2014;149:177–184. - PMC - PubMed
    1. Chok AY, Zhao Y, Tan IE, Au MKH, Tan EJKW. Cost-effectiveness comparison of minimally invasive, robotic and open approaches in colorectal surgery: a systematic review and bayesian network meta-analysis of randomized clinical trials. Int J Colorectal Dis. 2023;38:86. - PubMed
    1. Li W, Xiang XX, Da Wang H, Cai CJ, Cao YH, Liu T. Transanal endoscopic microsurgery versus radical resection for early-stage rectal cancer: a systematic review and meta- analysis. Int J Colorectal Dis. 2023;38:49. - PMC - PubMed
    1. Emile SH, Ragheb J. Toward less invasive coloproctology: The future is out there. World J Gastroenterol. 2024;30:199–203. - PMC - PubMed