Colon Polypectomy: Current Techniques and Novel Perspectives

158 Pages·2018·4.28 MB·English

by  Antonio Facciorusso,Nicola Muscatiello (eds.)

Colon
Polypectomy
Current Techniques and
Novel Perspectives
Antonio Facciorusso
Nicola Muscatiello
Editors
123
Colon Polypectomy
Antonio Facciorusso • Nicola Muscatiello
Editors
Colon Polypectomy
Current Techniques and Novel
Perspectives
Editors
Antonio Facciorusso Nicola Muscatiello
Gastroenterology Unit, Department Gastroenterology Unit, Department
of Medical Sciences of Medical Sciences
University of Foggia University of Foggia
Foggia, Italy Foggia, Italy
ISBN 978-3-319-59456-9 ISBN 978-3-319-59457-6 (eBook)
https://doi.org/10.1007/978-3-319-59457-6
Library of Congress Control Number: 2017960824
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continuous and enthusiastic support
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Preface
Since its introduction in clinical practice in the early 1970s, colon polypectomy has
become a standard procedure for treating noninvasive mucosal adenomas and neo-
plasms, with the aim to interrupt the adenoma-carcinoma sequence leading to inva-
sive cancer.
However, despite proven effectiveness, polypectomy techniques are often het-
erogeneous and lack complete standardization, particularly in some aspects such as
submucosal injection solutions or resection methods.
Proper removal of polyp needs not only technical skill but also complete and
updated knowledge of endoscopic equipment and awareness of potential complica-
tions according to morphology and size of the mucosal lesion.
In the colorectal cancer screening era, detection and resection of all polypoid
lesions are the main goals of quality colonoscopy, and submitting all resected pol-
yps to pathologic examination still represents the standard of care.
Furthermore, other important aspects play a fundamental role in this setting, par-
ticularly increasing adenoma detection rate during screening colonoscopy and
scheduling a proper surveillance program according to polyp features. Finally, the
endoscopist should take into account other patient-related characteristics which
may increase the risk of complications, such as ongoing therapy with antithrom-
botic agents or concomitant systemic disease.
For these reasons, it seemed rational to produce a book that represents much of
the current evidence and controversies on colon polypectomy. In order to overcome
bias related to a single-center experience, outstanding experts from all over the
world have been invited to contribute to this project.
This is an exciting time to be in the field of endoscopy as so many changes are
simultaneously occurring at multiple levels of our understanding, and there is an
increasing interest toward new techniques which have been recently developed.
We are confident our book will be of interest either to the expert endoscopist who
wants to stay abreast with the novel advancements in the field or to the trainees who
will likely benefit from authors’ experience to improve their skills.
Foggia, Italy Antonio Facciorusso
July 2017 Nicola Muscatiello
vii
Contents
1 Classification of Colon Polyps and Risk
of Neoplastic Progression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Renato Cannizzaro, Raffaella Magris, Stefania Maiero, Mara
Fornasarig, and Vincenzo Canzonieri
2 Methods to Improve the Adenoma Detection Rate . . . . . . . . . . . . . . . 13
Vasilios Papadopoulos and Konstantinos Triantafyllou
3 Non-polypoid Colorectal Neoplasms:
Characteristics and Endoscopic Management . . . . . . . . . . . . . . . . . . . 33
Maria Antonia Bianco, Cristina Bucci, and Fabiana Zingone
4 Colonoscopic Polypectomy: Current Techniques and
Controversies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Fabio Monica and Giulia Maria Pecoraro
5 Advanced Endoscopic Resection of Colorectal Lesions . . . . . . . . . . . . 61
Jessica X. Yu, Roy Soetikno, and Tonya Kaltenbach
6 Colorectal Endoscopic Submucosal Dissection . . . . . . . . . . . . . . . . . . 73
Federico Iacopini and Yutaka Saito
7 Submucosal Injection Solutions for Colon Polypectomy . . . . . . . . . . . 89
Antonio Facciorusso and Nicola Muscatiello
8 Management of Complications After Endoscopic Polypectomy . . . . . 107
Valentina Del Prete, Matteo Antonino, Rosario Vincenzo Buccino,
Nicola Muscatiello, and Antonio Facciorusso
9 Anticoagulants and Antiplatelet Agents
in Patients Undergoing Polypectomy . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Angelo Milano, Francesco Laterza, Konstantinos Efthymakis,
Antonella Bonitatibus, and Matteo Neri
10 Endoscopic Surveillance After Polypectomy . . . . . . . . . . . . . . . . . . . . 135
Giuseppe Galloro, Donato Alessandro Telesca, Teresa Russo,
Simona Ruggiero, and Cesare Formisano
11 Conclusive Remarks and New Perspectives . . . . . . . . . . . . . . . . . . . . . 147
Antonio Facciorusso and Nicola Muscatiello
ix
Contributors
Matteo Antonino Gastroenterology Unit, University of Foggia, Foggia, Italy
Maria Antonia Bianco Gastrointestinal Unit, ASL Na3 SUD, Torre del Greco,
Naples, Italy
Antonella  Bonitatibus Department of Medicine and Ageing Sciences,
“G. D’Annunzio” University, Chieti, Italy
Cristina Bucci Gastrointestinal Unit, ASL Na3 SUD, Torre del Greco, Naples, Italy
Rosario Vincenzo Buccino Gastroenterology Unit, University of Foggia, Foggia,
Italy
Renato Cannizzaro Gastroenterology Unit, Centro di Riferimento Oncologico,
IRCC, Aviano, Italy
Vincenzo Canzonieri Pathology Unit, Centro di Riferimento Oncologico, IRCCS,
Aviano, Italy
Valentina Del Prete Gastroenterology Unit, University of Foggia, Foggia, Italy
Konstantinos  Efthymakis Department of Medicine and Ageing Sciences,
“G. D’Annunzio” University, Chieti, Italy
Antonio Facciorusso Gastroenterology Unit, University of Foggia, Foggia, Italy
Cesare  Formisano Department of Clinical Medicine and Surgery, Surgical
Digestive Endoscopy Unit, University of Naples Federico II – School of Medicine,
Naples, Italy
Mara  Fornasarig Gastroenterology Unit, Centro di Riferimento Oncologico,
IRCCS, Aviano, Italy
Giuseppe  Galloro Department of Clinical Medicine and Surgery, Surgical
Digestive Endoscopy Unit, University of Naples Federico II – School of Medicine,
Naples, Italy
Federico  Iacopini Gastroenterology Endoscopy Unit, S.  Giuseppe Hospital,
Albano L., Rome, Italy
xi
xii Contributors
Tonya  Kaltenbach San Francisco Veterans Affairs Medical Center, San
FranciscoCA, USA
Francesco  Laterza Department of Medicine and Ageing Sciences,
“G. D’Annunzio” University, Chieti, Italy
Raffaella  Magris Gastroenterology Unit, Centro di Riferimento Oncologico,
IRCCS, Aviano, Italy
Stefania  Maiero Gastroenterology Unit, Centro di Riferimento Oncologico,
IRCCS, Aviano, Italy
Angelo Milano Department of Medicine and Ageing Sciences, “G. D’Annunzio”
University, Chieti, Italy
Fabio Monica Division of Gastroenterology and Digestive Endoscopy, Azienda
Sanitaria Universitaria Integrata di Trieste, Academic Hospital Cattinara, Trieste, Italy
Nicola Muscatiello Gastroenterology Unit, University of Foggia, Foggia, Italy
Matteo Neri Department of Medicine and Ageing Sciences, “G. D’Annunzio”
University, Chieti, Italy
Vasilios Papadopoulos Hepatogastroenterology Unit, National and Kapodistrian
University, Attikon University General Hospital, Athens, Greece
Giulia Maria Pecoraro Division of Gastroenterology and Digestive Endoscopy,
Azienda Sanitaria Universitaria Integrata di Trieste, Academic Hospital Cattinara,
Trieste, Italy
Simona  Ruggiero Department of Clinical Medicine and Surgery, Surgical
Digestive Endoscopy Unit, University of Naples Federico II – School of Medicine,
Naples, Italy
Teresa Russo Department of Clinical Medicine and Surgery, Surgical Digestive
Endoscopy Unit, University of Naples Federico II – School of Medicine, Naples,
Italy
Yutaka Saito Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
Roy Soetikno San Francisco Veterans Affairs Medical Center, San Francisco, CA,
USA
Donato  Alessandro  Telesca Department of Clinical Medicine and Surgery,
Surgical Digestive Endoscopy Unit, University of Naples Federico II – School of
Medicine, Naples, Italy
Konstantinos  Triantafyllou Hepatogastroenterology Unit, National and
Kapodistrian University, Attikon University General Hospital, Athens, Greece
Jessica X. Yu Division of Gastroenterology and Hepatology, Stanford University
School of Medicine, Stanford, CA, USA
Fabiana Zingone Gastrointestinal Unit, ASL Na3 SUD, Torre del Greco, Naples,
Italy
Classification of Colon Polyps and Risk 1
of Neoplastic Progression
Renato Cannizzaro, Raffaella Magris, Stefania Maiero,
Mara Fornasarig, and Vincenzo Canzonieri
1.1 Introduction
Intestinal polyps are projections from the mucosal surface that bulge into the vis-
ceral lumen and they are classified on the basis of their clinico-pathological quali-
ties (i.e., neoplastic versus non-neoplastic) (Table 1.1) and/or their histopathological
characteristics (Table 1.2). Adenomas are recognized as the precursor lesions for
colorectal carcinoma [1]. Endoscopically, any superficial intestinal lesion may be
described as follows: polypoid type (pedunculated, sessile, semi-pedunculated
lesions), non-polypoid type (slightly elevated, flat, slightly depressed lesions) [2, 3].
Table 1.1 Clinico- Neoplastic mucosal polyps
pathological classification Benign (adenoma)
of polyps Tubular adenoma
Tubulovillous adenoma
Villous adenoma
Malignant (carcinoma)
Noninvasive carcinoma
Carcinoma in situ
Intramucosal carcinoma
Invasive carcinoma (through muscularis mucosae)
Non-neoplastic mucosal polyps
Hyperplastic polyp (including serrated polyps)
Mucosal polyp (normal mucosa in a polypoid configuration)
Juvenile polyp (retention polyp)
Peutz–Jeghers polyp
Inflammatory polyp
R. Cannizzaro (*) • R. Magris • S. Maiero • M. Fornasarig
SOC Gastroenterologia Oncologica, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
e-mail: [email protected]
V. Canzonieri
SOC Anatomia Patologica, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
© Springer International Publishing AG 2018 1
A. Facciorusso, N. Muscatiello (eds.), Colon Polypectomy,
https://doi.org/10.1007/978-3-319-59457-6_1