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Management of complex polyps of the colon and rectum

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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.

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Acknowledgements

The authors would like to thank Dr. Paul Kortan (St. Michael’s Hospital, Toronto, ON, Canada) for providing feedback on this manuscript.

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Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada

    Fernando A. Angarita, Adina E. Feinberg, Stanley M. Feinberg & J. Andrea McCart

  2. Division of General Surgery, North York General Hospital, Toronto, ON, Canada

    Stanley M. Feinberg

  3. Departments of Pathobiology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada

    Robert H. Riddell

  4. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada

    Robert H. Riddell

  5. Department of Surgery, Mount Sinai Hospital, 600 University Avenue, Suite 1225, Toronto, ON, M5G 1X5, Canada

    J. Andrea McCart

  6. Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada

    J. Andrea McCart

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Angarita, F.A., Feinberg, A.E., Feinberg, S.M. et al. Management of complex polyps of the colon and rectum. Int J Colorectal Dis 33, 115–129 (2018). https://doi.org/10.1007/s00384-017-2950-1

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