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Colorectal endoscopic resection: What are the mistakes to avoid? Volume 26, supplement 2, Novembre 2019

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Authors
CHU de Nice, Hôpital de l’Archet 2, Pôle DARE, Unité d’Endoscopie Digestive, 151 route de Saint-Antoine de Ginestière, 06202 Nice
* Correspondance

Today, the majority of colonic polyps are accessible to endoscopic treatment, but several “traps” have to be avoided during the different steps of resection. Before resection, all the conditions for optimal management must be met from patient information, bowel preparation to equipment and trained team in endoscopy. All therapeutic endoscopy and resection should nowadays be performed under carbon dioxide (CO2) insufflation, which significantly reduces the number of complications. Polyp characterization is essential before any resection attempt. The international classifications (Kudo, Paris...) are useful to diagnose a lesion suspected of submucosal invasion, making an endoscopic procedure inconsiderate. Some “at risk” locations must also lead the operator to recognize his own limits and sometimes to know how to refer the patient to an expert center. A simple lifting or the carrying out of biopsies often makes the subsequent resection procedure difficult. The prevention of delayed bleeding by mechanical means and managing complications such as perforation are crucial steps. Finally, the conditioning of polyps and their histological analysis are as important steps as resection, as they are the next step in the management and monitoring of the patient.

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