How to avoid overtreatment of benign colorectal lesions: Rationale for an evidence-based management

Autores de IIS La Fe

• Marco Bustamante Balén

  Autor

Grupos

• Endoscopia Digestiva y Hepática

Abstract

Implementing population-based screening programs for colorectal cancer has led to an increase in the detection of large but benign histological lesions. Currently, endoscopic mucosal resection can be considered the standard technique for the removal of benign lesions of the colon due to its excellent safety profile and good clinical results. However, several studies from different geographic areas agree that many benign colon lesions are still referred for surgery. Moreover, the referral rate to surgery is not decreasing over the years, despite the theoretical improvement of endoscopic resection techniques. This article will review the leading causes for benign colorectal lesions to be referred for surgery and the influence of the endoscopist experience on the referral rate. It will also describe how to categorize a polyp as complex for resection and consider an endoscopist as an expert in endoscopic resection. And finally, we will propose a framework for the accurate and evidence-based treatment of complex benign colorectal lesions. © The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

Keywords

• Colonic Polyps; Colonoscopy; Colorectal Neoplasms; Endoscopic Mucosal Resection; Humans; Overtreatment; clinical practice; colorectal polyp; colorectal surgery; colorectal tumor; colostomy; endoscopic mucosal resection; endoscopic surgery; endoscopist; evidence based practice; health personnel attitude; hospitalization; human; ileostomy; laparoscopic surgery; medical expert; overtreatment; patient referral; postoperative complication; Review; colon polyp; colonoscopy; pathology; procedures