Advances, problems, and complications of polypectomy
نویسندگان
چکیده
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.
منابع مشابه
Resect and Discard Strategy: Why?
Introduction The prevalence of colorectal neoplasms is approximately 30-40% in asymptomatic average-risk Koreans, which is comparable with the rate in Western countries. Although colonoscopic polypectomy can decrease the incidence of colorectal cancer, polypectomy and the ensuing pathologic examinations are major determinants of the cost. However, pathologic examinations are used only for deter...
متن کاملHow Do I Manage Post-Polypectomy Bleeding?
Colonoscopic polypectomy is an effective method for prevention of colorectal cancer and has become one of the most common procedures worldwide. Most colorectal polyps can be removed safely by various polypectomy techniques; however, serious complications can occur. Postpolypectomy bleeding is the most common complication of colonoscopic polypectomy, accounting for 0.3% to 6.1% of polypectomy. T...
متن کاملDelayed Complications and Long-Term Management of Sulfur Mustard Poisoning: A Narrative Review of Recent Advances by Iranian Researchers Part ІІ: Clinical Management and Therapy
The present study aimed to review and discuss the recommended and recently suggested protocols by Iranian researchers for a long-term treatment of delayed complications of sulfur mustard (DCSM) in veterans. As indicated clinically, patients who suffer from delayed ocular complications of sulfur mustard (DOCS) benefit from treatments for dry eyes, therapeutic contact lenses, amniotic membrane tr...
متن کاملComplications of colonoscopy in an integrated health care delivery system.
BACKGROUND Information about colonoscopy complications, particularly postpolypectomy bleeding, is limited. OBJECTIVE To quantify the magnitude and severity of colonoscopy complications. DESIGN Retrospective cohort. SETTING Kaiser Permanente of Northern California. PATIENTS 16, 318 members 40 years of age or older undergoing colonoscopy between January 1994 and July 2002. MEASUREMENTS ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 7 شماره
صفحات -
تاریخ انتشار 2014