colonoscopy findings not polyps but lymph

The former usually require surgery, while the latter can be excised endoscopically (often piecemeal resection is sufficient). 4 The purpose of an optical diagnosis is to differentiate between cancers and premalignant polyps. 3 Modern polyp classification techniques (e.g., Paris, virtual chromoendoscopy and Kudo pit pattern) allow for an optical biopsy, including assessment of lesion location, size, morphology, granularity and surface pit or microvascular surface pattern. Patients having surgery for unresectable or high-risk polyps can face risks of complications and increased costs. Surgeon endoscopists must stay up to date on polyp classification as it can guide the subsequent management of patients with complex colorectal lesions. 2 Correctly identifying lesions that would benefit most from an advanced endoscopy procedure can be challenging. Colectomy remains the standard of care for more advanced lesions or those with risk factors for lymph node metastasis. However, these lesions should be removed all at once, often by an experienced endoscopist using advanced techniques such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). Early-stage T1 cancers without high-risk features for lymph node metastasis may also be removed endoscopically. 1 Endoscopic removal is appropriate for most polyps. Data from the United Kingdom show that nearly 10% of all malignant colon lesions will be found inside polyps. Widespread screening has increased the detection of early-stage colorectal cancers.

We aimed to provide an overview of polyp classification techniques to help surgeons select the correct treatment algorithm for advanced colorectal lesions based on their visual characteristics at index endoscopy.

A surgeon endoscopist must be able to recognize which complex polyps can be resected with advanced polypectomy techniques and which require upfront surgery.

The use of modern polyp classification techniques based on size, morphology and pit pattern by an experienced endoscopist allow for an optical diagnosis of these lesions and can predict, with high accuracy, which lesions contain malignant disease and the level of invasion. Endoscopic excision with negative margins is adequate for most polyps and low-risk T1 cancers. Increasing familiarity with advanced endoscopic excision techniques allows for more colorectal lesions to be removed without major surgery.

Colonoscopy findings not polyps but lymph