[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-379264-105":59,"doc-detail-379264-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","colorectal-polyp-classification-and-managementof-complex-polyps-for-surgeon-endoscopists","Colorectal polyp classification and managementof complex polyps for surgeon endoscopists","","Advanced endoscopic excision expertise supports removal of more colorectal lesions without major surgery, using negative margins for most polyps and low-risk T1 cancers. Modern optical polyp classification based on size, morphology, and pit pattern enables optical biopsy to predict malignant involvement and invasion level. Complex polyp assessment guides whether advanced resection techniques are appropriate or upfront surgery is required. The document outlines classification systems and decision-making for surgeon endoscopists to select patient-specific management.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/colorectal-polyp-classification-and-managementof-complex-polyps-for-surgeon-endoscopists/379264/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/colorectal-polyp-classification-and-managementof-complex-polyps-for-surgeon-endoscopists/379264.png","ImageObject",300,407,{"name":92,"@type":93},"Cipher","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why are advanced endoscopic excision techniques important for colorectal lesions?","Question",{"text":113,"@type":114},"They allow many colorectal lesions to be removed without major surgery, while aiming for complete resection with negative margins for most polyps and low-risk T1 cancers.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How do modern polyp classification techniques support an optical diagnosis?",{"text":118,"@type":114},"They use size, morphology, and pit pattern (e.g., Paris, virtual chromoendoscopy, Kudo pit pattern) to differentiate cancers from premalignant polyps and estimate invasion level with high accuracy.",{"name":120,"@type":111,"acceptedAnswer":121},"When should a surgeon endoscopist prefer surgery over advanced polypectomy?",{"text":122,"@type":114},"For lesions with higher-risk features for malignant disease or when resection with advanced polypectomy is uncertain, upfront surgery may be required; a second endoscopist opinion can help before radical resection.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},379264,1790472854,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":46},687208528416,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","# Colorectal polyp classification and managementof complex polyps for surgeon endoscopists\n\nGarrett G.R.J.Johnson,MD,MScRamzi Helewa,MD,MScDana C.Moffatt,MDJohn Gerard Coneys,MDJason Park,MD,MEdEric Hyun,MD,PhD  \nAccepted Jun.29,2023  \nCorrespondence to:  \nE.Hyun  \nZ3037-409 Taché AvenueWinnipeg,MB R2H 2A6ehyun@sbgh.mb.ca  \nCite as:Can JSurg 2023 September 21;  \n66(5).doi:10.1503/cjs.011422  \n## SUMMARY\n\nIncreasing familiarity with advanced endoscopic excision techniques allowsfor more colorectal lesions to be removed without major surgery.Endoscopicexcision with negative margins is adequate for most polyps and low-risk T1cancers.The use of modern polyp classification techniques based on size,morphology and pit pattern by an experienced endoscopist allow for anoptical diagnosis of these lesions and can predict,with high accuracy,whichlesions contain malignant disease and the level of invasion.A surgeonendoscopist must be able to recognize which complex polyps can be resectedwith advanced polypectomy techniques and which require upfront surgery.We aimed to provide an overview of polyp classification techniques to helpsurgeons select the correct treatment algorithm for advanced colorectallesions based on their visual characteristics at index endoscopy.  \nidespread screening has increased the detection of early-stagecolorectal cancers.Data from the United Kingdom show thatnearly 10%of all malignant colon lesions will be found insidepolyps.Endoscopic removal is appropriate for most polyps.Early-stage T1cancers without high-risk features for lymph node metastasis may also beremoved endoscopically.However,these lesions should be removed all at once,often by an experienced endoscopist using advanced techniques such asendoscopic mucosal resection (EMR)and endoscopic submucosal dissection(ESD).Colectomy remains the standard of care for more advanced lesions orthose with risk factors for lymph node metastasis.²Correctly identifying lesionsthat would benefit most from an advanced endoscopy procedure can bechallenging.  \nSurgeon endoscopists must stay up to date on polyp classification as it canguide the subsequent management of patients with complex colorectal lesions.Patients having surgery for unresectable or high-risk polyps can face risks ofcomplications and increased costs.³Modern polyp classification techniques(e.g.,Paris,virtual chromoendoscopy and Kudo pit pattern)allow for an opticalbiopsy,including assessment of lesion location,size,morphology,granularityand surface pit or microvascular surface pattern.The purpose of an opticaldiagnosis is to differentiate between cancers and premalignant polyps.Theformer usually require surgery,while the latter can be excised endoscopically(often piecemeal resection is sufficient)?Therefore,in cases of uncertainty,asecond opinion from an endoscopist who performs advanced endoscopytechniques should be sought before simply proceeding to radical resection.Endoscopic management may be particularly desirable for patients who wish toavoid surgery,such as older patients and those with complex or severalcomorbidities.Surgeons must select the appropriate intervention for theappropriate patient.  \nWe aimed to provide an overview for surgeon endoscopists for applyingtechniques to differentiate between malignant and nonmalignant lesionsusing optical characteristics available at index endoscopy.We also discuss the  \nmanagement of complex polyps and describe the decision-making process for surgeon endoscopists.  \nnarrow stalk,thus providing more separation between theneoplastic epithelium and the underlying colonic mucosa.Sessile(0-Is)or flat lesions(0-II)have less distancebetween abnormal tissue and the normal tissues below andless distance for a neoplastic mass to travel before enteringthe submucosal plane.Small polypoid lesions(0-I)withoutconcerning features are seldom malignant and can beremoved endoscopically.Conversely,lesions withdepression(0-IIc)are associated with an increased risk ofmalignant dise","cbCaihesuErj667J","https://ap.wps.com/l/cbCaihesuErj667J","pdf",2956250,"English","# SUMMARY\n## Polyp classification and optical diagnosis\n## POLYP CLASSIFICATION\n### Polyp morphology","[{\"question\":\"Why are advanced endoscopic excision techniques important for colorectal lesions?\",\"answer\":\"They allow many colorectal lesions to be removed without major surgery, while aiming for complete resection with negative margins for most polyps and low-risk T1 cancers.\"},{\"question\":\"How do modern polyp classification techniques support an optical diagnosis?\",\"answer\":\"They use size, morphology, and pit pattern (e.g., Paris, virtual chromoendoscopy, Kudo pit pattern) to differentiate cancers from premalignant polyps and estimate invasion level with high accuracy.\"},{\"question\":\"When should a surgeon endoscopist prefer surgery over advanced polypectomy?\",\"answer\":\"For lesions with higher-risk features for malignant disease or when resection with advanced polypectomy is uncertain, upfront surgery may be required; a second endoscopist opinion can help before radical resection.\"}]","Colorectal polyp classification and managementof complex polyps for surgeon endoscopists | PDF",1790234796]