Colon Polypectomy: Current Techniques and Novel Perspectives PDF
Preview Colon Polypectomy: Current Techniques and Novel Perspectives
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 © Springer International Publishing AG 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recita- tion, broadcasting, reproduction on microfilms or in any other physical way, and transmission or infor- mation storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publica- tion does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland To our Director-General Antonio Pedota and our Medical Director Laura Moffa for their continuous and enthusiastic support The greatest good you can do for another is not just to share your riches but to reveal to him his own. – Benjamin Disraeli 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
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