Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Malignant polyps are now being encountered more frequently because of increased colorectal cancer screening. Endoscopy offers a minimally invasive option for treating some malignant polyps thus reducing surgical morbidity and mortality. This chapter reviews the endoscopic assessment of colorectal polypoid lesions and risk stratification using gross polyp morphology (Paris classification), lesion surface appearance (Kudo pit pattern and mucosal microvessel appearance, via high-magnification chromoendoscopy and narrow-band imaging), and by the lesion's lifting characteristics ("nonlifting sign"). In combination, these features allow an assessment of the potential for malignancy as well as the likely depth of submucosal invasion, so as to guide appropriate management. We also consider possible adjunct assessment modalities, such as endoscopic ultrasound, and discuss postpolypectomy histologic classification, including Haggitt staging for pedunculated lesions and Kikuchi staging for sessile lesions or laterally spreading tumors. Finally, we describe endoscopic resection techniques for removal of malignant polyps, including endoscopic mucosal resection and endoscopic submucosal dissection, and compare these with surgical management options. © 2013 Elsevier Inc.

Original publication

DOI

10.1016/j.tgie.2013.02.006

Type

Journal article

Journal

Techniques in Gastrointestinal Endoscopy

Publication Date

01/04/2013

Volume

15

Pages

106 - 112