Successful endoscopic strategies for difficult polypectomy.
OBJECTIVE
Standard endoscopic polypectomy is a powerful technique to remove most polyps found in the gastrointestinal tract. However, a small percentage of polyps can be classified as difficult, based on size, location, and/or configuration. Traditionally, these difficult polyps were referred for surgical segmental colectomy. Recently, with advancements in endoscopic techniques and accessories, a majority of these difficult polyps are now able to be completely resected using entirely endoscopic techniques.


RESULTS
Endoscopic techniques and accessories have been evolving during recent years, including increased dissemination of techniques of endoscopic submucosal dissection to the western hemisphere. In addition to refinement of endoscopic techniques, there has been increased interest in developing improved endoscopic accessories, including novel submucosal injectate with auto-dissecting properties, to improve safety and efficiency of endoscopic resection of difficult polyps.


CONCLUSIONS
This article will review currently available techniques and strategies for successful endoscopic resection for difficult polyps.
Gastroenterology Department of Changhai Hospital, Second Military Medical University, Shanghai, China.
MinMin
M
Zhang
Eun J
EJ
Shin
D003082:Colectomy / Q000379:methods; D003111:Colonic Polyps / Q000601:surgery; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods*; D004210:Dissection / Q000379:methods; D006801:Humans; D007417:Intestinal Polyps / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods