Colon Polyps Extending Across an Anastomosis Can Be Effectively Removed by Endoscopic Mucosal Resection

Colorectal

Douglas K. Rex, MD, MASGE reviewing Cronin O, et al. Endoscopy 2023 Sep 12.

Among 2629 large nonpedunculated colorectal polyps in 2350 patients, 10 were classified as anastomotic and had a median lesion size of 35 mm. All lesions were removed by combined use of piecemeal endoscopic mucosal resection (EMR) and cold-forceps avulsion with adjuvant snare-tip soft coagulation.

All 10 lesions were successfully treated, with no recurrence at the 6-month (first) follow-up in 10 of 10 cases and none at the second follow-up in 9 of 9 cases.

Comment:

These data indicate that polyps growing over an anastomosis can be effectively treated by standard piecemeal EMR plus an avulsion technique to deal with fibrosis. They generally do not require endoscopic submucosal dissection for success, and of course, they usually do not require repeat surgical resection.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

Douglas K. Rex, MD, MASGE

Bio and Disclosures

Citation(s):

Cronin O, Gupta S, Gauci J, et al. Endoscopic resection of large anastomotic polyps is safe and effective. Endoscopy 2023 Sep 12. (Epub ahead of print) (https://doi.org/10.1055/a-2174-2967)