The article examines whether surgical resection can be avoided in some patients after a malignant colorectal polyp has been removed endoscopically. Traditionally, surgery has been recommended because of concerns about residual cancer or lymph node involvement, but the article highlights growing discussion around selective non-surgical management.
Key themes covered in the article:
- Not all malignant polyps behave the same.
The article emphasizes that outcomes vary depending on pathologic features of the polyp, rather than malignancy alone. - Carefully selected patients may not always need surgery.
In cases where the polyp appears to be completely removed and has favorable characteristics on pathology, clinicians are increasingly questioning whether immediate colectomy is necessary. - Risk stratification is central to decision-making.
The discussion focuses on how histologic assessment after polypectomy informs whether observation could be reasonable versus when surgery remains the safer option. - The decision is nuanced and individualized.
The article underscores that management should be based on pathology findings, patient factors, and shared decision-making rather than a one-size-fits-all rule. - Surgery remains standard in many cases.
While the idea of avoiding surgery is gaining attention, the article does not suggest abandoning surgery broadly—only reconsidering it in narrowly defined situations.