67 year old lady was found to have a large laterally spreading lesion in her proximal colon.
Patients who are candidates for endoscopic removal of large colon polyps include those in whom the concern for invasive cancer is low and the size and location of the polyp are amenable to endoscopic resection with a low risk of complications.
There are a number of approaches to colonic polyp removal:
Snare polypectomy – large pedunculated polyps can typically be removed by transecting the stalk of the polyp with electrocautery
Endoscopic mucosal resection (EMR) – this technique is more suitable for large sessile polyps as in this case, where EMR was employed to achieve complete removal. The lesion is usually removed piecemeal.
Endoscopic submucosal dissection (ESD) – is a variant of EMR in which a specialised needle knife is used to dissect lesions away from the submucosa, in one piece. This technique is typically not required for colon polyps because the majority of colon polyps are benign, so they can be removed piecemeal with a low recurrence risk.
