Gastroenterology clinic

Endoscopic management of large colonic polyps

Josh Butt, Gregor Brown



Most large colonic polyps can now be assessed and removed endoscopically, avoiding the need for surgical resection.

Article Extract

  • Most colorectal cancers arise from colonic polyps. Unsurprisingly, polypectomy has been shown to reduce both the expected incidence and mortality of colorectal cancer.
  • Large (20 mm or more) colonic polyps are relatively uncommon; over 90% of polyps detected at colonoscopy are 10 mm or less.
  • In the past, patients with large polyps were referred for surgical resection because safe and effective endoscopic polypectomy techniques were not available.
  • With modern endoscopic techniques virtually any benign polyp can now be safely and completely removed at day-procedure colonoscopy.
  • Given the ability to remove even very large colonic polyps endoscopically, the risk of malignancy is the main determinant of whether surgery is required.