Surgical vs Endoscopic Excision of Large Colon Polyps (MDedge)

The management of large colorectal polyps has significantly advanced with the rise of endoscopic techniques such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), minimizing the need for surgical intervention. Drs. Moamen Gabr and Jeffrey Mosko highlight the safety, cost-effectiveness, and precision of endoscopic resection, emphasizing that most polyps can be removed endoscopically with low recurrence rates. However, Dr. Ira Leeds, a colorectal surgeon, urges caution, particularly for rectal and cecal lesions, where surgical approaches such as transanal minimally invasive surgery (TAMIS) or laparoscopic colectomy may offer advantages in specimen quality, risk stratification, and long-term surveillance. The discussion underscores the importance of multidisciplinary decision-making to ensure optimal patient outcomes.