Ngamruengphong S.,The Johns Hopkins Medical Institutions |
Pohl H.,Dartmouth Hitchcock Medical Center |
Pohl H.,Medical Center White River Junction |
Haito-Chavez Y.,The Johns Hopkins Medical Institutions |
Khashab M.A.,The Johns Hopkins Medical Institutions
Current Gastroenterology Reports | Year: 2016
Endoscopists often encounter colon polyps that are technically difficult to resect. These lesions traditionally were managed surgically, with significant potential morbidity and mortality. Recent advances in endoscopic techniques and instruments have allowed endoscopists to safely and effectively remove colorectal lesions with high technical and clinical success and potentially avoid invasive surgery. Endoscopic mucosal resection (EMR) has gained acceptance as the first-line therapy for large colorectal lesions. Endoscopic submucosal dissection (ESD) has been reported to be associated with higher rate of en bloc resection and less risk of short-time recurrence, but with an increased risk of adverse events. Therefore, the role of colorectal ESD should be restricted to lesions with high-risk morphologic features of submucosal invasion. In this article, we review the recent literature on the endoscopic management of difficult colorectal neoplasms. © 2015, Springer Science+Business Media New York.