Gut Check on Gastroenterology Archive

Gut Check on Gastroenterology, an NEJM Journal Watch blog focusing on issues in clinical gastroenterology, was active from 2008 to 2014. This archive contains all posts and discussions from Gut Check’s history.

December 9th, 2013

Are You Removing Diminutive Colonic Polyps with a Forceps?

Small colorectal polyps are commonly encountered during colonoscopy, and their removal is important in colorectal cancer prevention. These smaller lesions (≤5 mm) are relatively easy to remove — usually done by either forceps “biopsy” or mini-snare polypectomy. The choice of removal tool is often based on operator preference, but with forceps biopsy removal, recovering the lesion is easier and seemingly quicker. However, recent data suggest that forceps biopsy is less effective than snare polypectomy at total polyp removal.

So, given that this remains a gray area in terms of best practices, what I would like to know is:

  • How do you remove small (≤5 mm) polyps detected during colonoscopy?
  • Do you use one technique exclusively?
  • Do you comment on whether the polyp appears to be totally removed?
  • After you remove a polyp, do you review the pathology report to see if there is a margin of normal tissue?
  • What evidence would make you change your preference?

Looking forward to your responses.

 

Categories: cancer surveillance, colonoscopy, polypectomy


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Gastroenterology Research: Author M. Brian Fennerty, M.D.

M. Brian Fennerty, MD

Editor-in-Chief

NEJM Journal Watch Gastroenterology

Biography | Disclosures | Summaries

Learn more about Gut Check on Gastroenterology.