John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive


Endoscopic resection of small colorectal polyps? Volume 26, issue 2, Février 2019


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1 Hôpital Européen Georges Pompidou, Service d’hépato-gastroentérologie, 20 rue Leblanc, 75015 Paris
2 Université Paris Descartes, Faculté de médecine, 15 rue de l’école de médecine, 75006 Paris
* Correspondance

Polyps smaller than 10 mm are the most common lesions encountered during screening colonoscopy and are associated with low risk of colorectal cancer. These lesions are classified according to their size as diminutive polyps (< 5 mm) or small polyps (6-9 mm). Despite improvement in real time characterisation techniques, small polyps must be endoscopically resected. Strategies such as “resect and discard” or “diagnosed and leave behind” are dedicated to expert centres with a high degree of confidence in optical diagnosis. Many endoscopic techniques are available for polyps resection, whose effectiveness is variable in the literature. Incomplete resection rates range from 7% to 10% and are responsible for up to 27% of interval cancer. The European Society of Digestive Endoscopy established in 2012 (updated in 2017) recommendations for the resection of small polyps. Cold snare resection is the gold standard for these polyps because it is associated with a high rate of complete resection, a better histological analysis and a low rate of complications. In case of difficult positioning, the use of the cold biopsy forceps can be used for very small polyps (<4 mm). The use of hot biopsy forceps should be proscribed as it is associated with a low rate of complete resection and post resection complications.

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