You find a 2.3 cm polyp in the right colon during a screening colonoscopy.  Does this patient need a colectomy? Is polypectomy ok? What should I do?? Join Drs. Peter Marcello, Jonathan Abelson and Tess Aulet as they discuss the endoscopic management of advanced colorectal polyps. 

Be sure to check out Behind the Knife's YouTube channel for the VideoCast version of this high-yield case: https://www.youtube.com/c/BehindTheKnifeTheSurgeryPodcast.  

Interested in learning more about specific topics in Colorectal Surgery? Check out the Virtual Education Series in Colorectal Surgery on Sunday Evenings at 7 pm EST @CRSVirtualEd or visit our website at http://jc.kethman.org.

References:

Cohan JN, Donahue C, Pantel HJ, Ricciardi R, Kleiman DA, Read TE, Marcello PW. Endoscopic Step Up: A Colon-Sparing Alternative to Colectomy to Improve Outcomes and Reduce Costs for Patients With Advanced Neoplastic Polyps. Dis Colon Rectum. 2020 Jun;63(6):842-849. doi: 10.1097/DCR.0000000000001645. PMID: 32118624.
https://pubmed.ncbi.nlm.nih.gov/32118624/

NCCN guidelines: https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1428

Kudo Classification: Kudo S, Tamura S, Nakajima T, Yamano H, Kusaka H, Watanabe H. Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointest Endosc 1996; 44: 8-14 [PMID:8836710]

UpToDate. Chromoendoscopy. Author:Marcia Irene Canto, MD, MHSSection Editor:John R Saltzman, MD, FACP, FACG, FASGE, AGAFDeputy Editor:Kristen M Robson, MD, MBA, FACG. Literature review current through: May 2021. | This topic last updated: Jan 14, 2021.

Haggit and Kikuchi classification: Haggitt RC, Glotzbch RE, Soffer EE, Wruble LD. Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy. Gastroenterology 1985; 89: 328-36.