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Much of the flat or biopsy-only detected dysplasia in inflammatory bowel disease (IBD) that had historically warranted a colectomy can now be shown to be circumscribed lesions with dye-spray or advanced endoscopic imaging. These lesions are therefore amenable to endoscopic excision with close endoscopic follow-up, though are technically very challenging. This review discusses preresection assessment of nonpolypoid or flat (Paris 0-II) lesions in colitis; lifting with colloids or hyaluronate; endoscopic mucosal resection (EMR) with spiral or flat ribbon snares; or simplified, hybrid, and full endoscopic submucosal dissection (ESD); as well as mucosal ablation. Close follow-up postresection is mandatory.

Original publication




Journal article


Gastrointest Endosc Clin N Am

Publication Date





435 - 445


ALM, Colitis, Colonic polyp, Colonoscopy, Colorectal cancer, DALM, Endoscopic mucosal resection, Endoscopic submucosal dissection, Argon Plasma Coagulation, Colon, Colonoscopy, Colorectal Neoplasms, Dissection, Humans, Inflammatory Bowel Diseases, Intestinal Mucosa, Precancerous Conditions