Colonofiberscopic management of colonic polyps

Abstract

Conclusions Endoscopic removal of 343 colonic polyps more than 0.5 cm in size, located from the cecum to the sigmoid colon and beyond the reach of rigid sigmoidoscopes, is reported. Diagnostic colonofiberscopy is a valuable procedure permitting direct visual examination of the entire colon with a high degree of safety. More than 1,800 diagnostic colonofiberscopies have been performed in our unit without a single complication. The polypectomy procedures via the colonofiberscope were done without mortality and with only a single immediate complication, which responded to conservative measures. Endoscopic removal of colonic polyps is proposed as a safe, practical alternative to either laparotomy and colotomy or repeated barium-enema studies in the management of the patient with a colonic polyp. The endoscopic approach allows differentiation of malignant from nonmalignant polyps by complete excision, thus permitting definitive cancer therapy measures to be undertaken promptly and with assurance. Endoscopic removal of colonic polyps is not advised for endoscopists who have not first achieved considerable experience and dexterity in diagnostic colonoscopy. Endoscopic removal of colonic polyps is best accomplished by an experienced endoscopist supported by the full spectrum of general hospital resources, after the patient has been thoroughly evaluated medically. It should be carried out on an inpatient basis. When a patient has a colonic polyp, an alert should be maintained for unsuspected colonic cancer unrelated to the polyp, lest the less serious lesion monopolize the clinical situation.