CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(05): E713-E715
DOI: 10.1055/a-1373-5176

Overutilization of surgery for the resection of benign colorectal lesions: the hidden reasons for inappropriate referral!

Mathieu Pioche
1   Hepatogastroenterology division, Edouard Herriot Hospital, Hospices civils de Lyon, France
Eddy Cotte
2   Department of digestive and oncological surgery, Lyon Sud Hospital, Hospices Civils de Lyon, France
Cesare Hassan
3   Department of gastroenterology and endoscopy, Nuovo Regina Margherita Hospital Rome, Italy
› Author Affiliations

At the beginning, it was surgery! Surgery was the only pre-endoscopic technique to remove colorectal polyps detected at barium enema or proctoscopy. When endoscopic polypectomy was introduced, it was clear that most of the polyps could be removed noninvasively. In the pre-endoscopic mucosal resection (EMR) era, however, a gray area between endoscopy and surgery remained. When dealing with benign-appearing lesions, it was unofficially assumed that lesions > 4 cm or expanding in more than two consecutive folds were to be treated surgically. BIG size, BIG treatment! Such a paradigm was somewhat facilitated by the implementation of laparoscopic colorectal surgery, which was believed to minimize surgery-related morbidity, especially in the right colon.

Publication History

Article published online:
22 April 2021

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