| Theme | Update on Management of Colorectal Polyp | |
|---|---|---|
| Title | Management of Colorectal Polyps ≤10 mm | |
| Publish Date | 2019/08 | |
| Author | Hiroyuki Hatamori | Division of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Resarch |
| Author | Shoichi Saito | Division of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Resarch |
| Author | Daisuke Ide | Division of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Resarch |
| Author | Akiko Chino | Division of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Resarch |
| Author | Masahiro Igarashi | Division of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Resarch |
| [ Summary ] | Recently, cold snare polypectomy (CSP) is being widely used as a method of endoscopic resection that does not use high‒frequency current for colorectal polyps ≤10 mm. CSP should be performed for sessile or semi‒pedunculated benign polyps. Malignant polyps or pedunculated polyps should be treated by polypectomy that uses high‒frequency current. Therefore, endoscopic diagnosis is essential to choose an appropriate treatment. White light observation is the basis of endoscopic diagnosis, while an accurate diagnosis is sometimes difficult with only white light observation. Irregular findings by magnifying narrow‒band imaging (NBI) are useful for differentiating malignant polyps from benign polyps according to the JNET classification. Normal/hyperplastic polyp/sessile serrated polyps were classified as type 1, low‒grade intramucosal neoplasia including intramucosal cancer with low‒grade structural atypia as type 2A, high‒grade intramucosal neoplasia/shallow submucosal invasive cancer as type 2B, and deep submucosal invasive cancer as type 3 according to the JNET classification. Therefore, polyps that were diagnosed as type 2B or 3 should be treated by polypectomy that uses high‒frequency current. |
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