Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.
Identifieur interne : 000F53 ( Main/Merge ); précédent : 000F52; suivant : 000F54Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.
Auteurs : Monika Ferlitsch [Autriche] ; Alan Moss [Australie] ; Cesare Hassan [Italie] ; Pradeep Bhandari [Royaume-Uni] ; Jean-Marc Dumonceau [Argentine] ; Gregorios Paspatis [Grèce] ; Rodrigo Jover [Espagne] ; Cord Langner [Autriche] ; Maxime Bronzwaer [Pays-Bas] ; Kumanan Nalankilli [Australie] ; Paul Fockens [Pays-Bas] ; Rawi Hazzan [Israël] ; Ian M. Gralnek [Israël] ; Michael Gschwantler ; Elisabeth Waldmann [Autriche] ; Philip Jeschek [Autriche] ; Daniela Penz [Autriche] ; Denis Heresbach [France] ; Leon Moons [Pays-Bas] ; Arnaud Lemmers [Belgique] ; Konstantina Paraskeva [Grèce] ; Juergen Pohl [Allemagne] ; Thierry Ponchon [France] ; Jaroslaw Regula [Pologne] ; Alessandro Repici [Italie] ; Matthew D. Rutter [Royaume-Uni] ; Nicholas G. Burgess [Australie] ; Michael J. Bourke [Australie]Source :
- Endoscopy [ 1438-8812 ] ; 2017.
Descripteurs français
- KwdFr :
- Algorithmes, Coloscopie (), Coloscopie (instrumentation), Coloscopie (normes), Complications postopératoires (), Complications postopératoires (diagnostic), Complications postopératoires (étiologie), Côlon (), Côlon (anatomopathologie), Côlon (imagerie diagnostique), Humains, Mucosectomie endoscopique (), Mucosectomie endoscopique (instrumentation), Mucosectomie endoscopique (normes), Polypes adénomateux (), Polypes adénomateux (anatomopathologie), Polypes adénomateux (imagerie diagnostique), Polypes intestinaux (), Polypes intestinaux (anatomopathologie), Polypes intestinaux (imagerie diagnostique), Rectum (), Rectum (anatomopathologie), Rectum (imagerie diagnostique), Tumeurs colorectales (), Tumeurs colorectales (anatomopathologie), Tumeurs colorectales (imagerie diagnostique).
- MESH :
- anatomopathologie : Côlon, Polypes adénomateux, Polypes intestinaux, Rectum, Tumeurs colorectales.
- diagnostic : Complications postopératoires.
- imagerie diagnostique : Côlon, Polypes adénomateux, Polypes intestinaux, Rectum, Tumeurs colorectales.
- normes : Coloscopie, Mucosectomie endoscopique.
- étiologie : Coloscopie, Complications postopératoires, Mucosectomie endoscopique.
- Algorithmes, Coloscopie, Complications postopératoires, Côlon, Humains, Mucosectomie endoscopique, Polypes adénomateux, Polypes intestinaux, Rectum, Tumeurs colorectales.
English descriptors
- KwdEn :
- Adenomatous Polyps (diagnostic imaging), Adenomatous Polyps (pathology), Adenomatous Polyps (surgery), Algorithms, Colon (diagnostic imaging), Colon (pathology), Colon (surgery), Colonoscopy (instrumentation), Colonoscopy (methods), Colonoscopy (standards), Colorectal Neoplasms (diagnostic imaging), Colorectal Neoplasms (pathology), Colorectal Neoplasms (surgery), Endoscopic Mucosal Resection (instrumentation), Endoscopic Mucosal Resection (methods), Endoscopic Mucosal Resection (standards), Humans, Intestinal Polyps (diagnostic imaging), Intestinal Polyps (pathology), Intestinal Polyps (surgery), Postoperative Complications (diagnosis), Postoperative Complications (etiology), Postoperative Complications (prevention & control), Rectum (diagnostic imaging), Rectum (pathology), Rectum (surgery).
- MESH :
- diagnosis : Postoperative Complications.
- diagnostic imaging : Adenomatous Polyps, Colon, Colorectal Neoplasms, Intestinal Polyps, Rectum.
- etiology : Postoperative Complications.
- instrumentation : Colonoscopy, Endoscopic Mucosal Resection.
- methods : Colonoscopy, Endoscopic Mucosal Resection.
- pathology : Adenomatous Polyps, Colon, Colorectal Neoplasms, Intestinal Polyps, Rectum.
- prevention & control : Postoperative Complications.
- standards : Colonoscopy, Endoscopic Mucosal Resection.
- surgery : Adenomatous Polyps, Colon, Colorectal Neoplasms, Intestinal Polyps, Rectum.
- Algorithms, Humans.
Abstract
1 ESGE recommends cold snare polypectomy (CSP) as the preferred technique for removal of diminutive polyps (size ≤ 5 mm). This technique has high rates of complete resection, adequate tissue sampling for histology, and low complication rates. (High quality evidence, strong recommendation.) 2 ESGE suggests CSP for sessile polyps 6 - 9 mm in size because of its superior safety profile, although evidence comparing efficacy with hot snare polypectomy (HSP) is lacking. (Moderate quality evidence, weak recommendation.) 3 ESGE suggests HSP (with or without submucosal injection) for removal of sessile polyps 10 - 19 mm in size. In most cases deep thermal injury is a potential risk and thus submucosal injection prior to HSP should be considered. (Low quality evidence, strong recommendation.) 4 ESGE recommends HSP for pedunculated polyps. To prevent bleeding in pedunculated colorectal polyps with head ≥ 20 mm or a stalk ≥ 10 mm in diameter, ESGE recommends pretreatment of the stalk with injection of dilute adrenaline and/or mechanical hemostasis. (Moderate quality evidence, strong recommendation.) 5 ESGE recommends that the goals of endoscopic mucosal resection (EMR) are to achieve a completely snare-resected lesion in the safest minimum number of pieces, with adequate margins and without need for adjunctive ablative techniques. (Low quality evidence; strong recommendation.) 6 ESGE recommends careful lesion assessment prior to EMR to identify features suggestive of poor outcome. Features associated with incomplete resection or recurrence include lesion size > 40 mm, ileocecal valve location, prior failed attempts at resection, and size, morphology, site, and access (SMSA) level 4. (Moderate quality evidence; strong recommendation.) 7 For intraprocedural bleeding, ESGE recommends endoscopic coagulation (snare-tip soft coagulation or coagulating forceps) or mechanical therapy, with or without the combined use of dilute adrenaline injection. (Low quality evidence, strong recommendation.)An algorithm of polypectomy recommendations according to shape and size of polyps is given (Fig. 1).
DOI: 10.1055/s-0043-102569
PubMed: 28212588
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pubmed:28212588Le document en format XML
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<author><name sortKey="Lemmers, Arnaud" sort="Lemmers, Arnaud" uniqKey="Lemmers A" first="Arnaud" last="Lemmers">Arnaud Lemmers</name>
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<wicri:regionArea>Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels</wicri:regionArea>
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<author><name sortKey="Paraskeva, Konstantina" sort="Paraskeva, Konstantina" uniqKey="Paraskeva K" first="Konstantina" last="Paraskeva">Konstantina Paraskeva</name>
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<author><name sortKey="Pohl, Juergen" sort="Pohl, Juergen" uniqKey="Pohl J" first="Juergen" last="Pohl">Juergen Pohl</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Gastroenterology, Asklepios Klinik Altona, Hamburg, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Gastroenterology, Asklepios Klinik Altona, Hamburg</wicri:regionArea>
<placeName><settlement type="city">Hambourg</settlement>
<region type="land" nuts="2">Hambourg</region>
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<author><name sortKey="Ponchon, Thierry" sort="Ponchon, Thierry" uniqKey="Ponchon T" first="Thierry" last="Ponchon">Thierry Ponchon</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Endoscopy and Gastroenterology, Edouard Herriot Hospital, Lyon, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Endoscopy and Gastroenterology, Edouard Herriot Hospital, Lyon</wicri:regionArea>
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<author><name sortKey="Regula, Jaroslaw" sort="Regula, Jaroslaw" uniqKey="Regula J" first="Jaroslaw" last="Regula">Jaroslaw Regula</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Gastroenterology, Maria Sklodowska-Curie Memorial CancerCenter and Medical Centre for Postgraduate Education, Warsaw, Poland.</nlm:affiliation>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Department of Gastroenterology, Maria Sklodowska-Curie Memorial CancerCenter and Medical Centre for Postgraduate Education, Warsaw</wicri:regionArea>
<wicri:noRegion>Warsaw</wicri:noRegion>
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<author><name sortKey="Repici, Alessandro" sort="Repici, Alessandro" uniqKey="Repici A" first="Alessandro" last="Repici">Alessandro Repici</name>
<affiliation wicri:level="3"><nlm:affiliation>Humanitas Research Hospital, Humanitas University, Rozzano, Milan, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Humanitas Research Hospital, Humanitas University, Rozzano, Milan</wicri:regionArea>
<placeName><settlement type="city">Milan</settlement>
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<author><name sortKey="Rutter, Matthew D" sort="Rutter, Matthew D" uniqKey="Rutter M" first="Matthew D" last="Rutter">Matthew D. Rutter</name>
<affiliation wicri:level="1"><nlm:affiliation>School of Medicine, Pharmacy and Health, Durham University, Durham, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>School of Medicine, Pharmacy and Health, Durham University, Durham</wicri:regionArea>
<wicri:noRegion>Durham</wicri:noRegion>
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<author><name sortKey="Burgess, Nicholas G" sort="Burgess, Nicholas G" uniqKey="Burgess N" first="Nicholas G" last="Burgess">Nicholas G. Burgess</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney</wicri:regionArea>
<placeName><settlement type="city">Sydney</settlement>
<region type="état">Nouvelle-Galles du Sud</region>
</placeName>
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<author><name sortKey="Bourke, Michael J" sort="Bourke, Michael J" uniqKey="Bourke M" first="Michael J" last="Bourke">Michael J. Bourke</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney</wicri:regionArea>
<placeName><settlement type="city">Sydney</settlement>
<region type="état">Nouvelle-Galles du Sud</region>
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</author>
<author><name sortKey="Moss, Alan" sort="Moss, Alan" uniqKey="Moss A" first="Alan" last="Moss">Alan Moss</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Endoscopic Services, Western Health, Melbourne, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Endoscopic Services, Western Health, Melbourne</wicri:regionArea>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Hassan, Cesare" sort="Hassan, Cesare" uniqKey="Hassan C" first="Cesare" last="Hassan">Cesare Hassan</name>
<affiliation wicri:level="3"><nlm:affiliation>Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome</wicri:regionArea>
<placeName><settlement type="city">Rome</settlement>
<region nuts="2">Latium</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Bhandari, Pradeep" sort="Bhandari, Pradeep" uniqKey="Bhandari P" first="Pradeep" last="Bhandari">Pradeep Bhandari</name>
<affiliation wicri:level="1"><nlm:affiliation>Solent Centre for Digestive Diseases, Queen Alexandra Hospital, Portsmouth, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Solent Centre for Digestive Diseases, Queen Alexandra Hospital, Portsmouth</wicri:regionArea>
<wicri:noRegion>Portsmouth</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Dumonceau, Jean Marc" sort="Dumonceau, Jean Marc" uniqKey="Dumonceau J" first="Jean-Marc" last="Dumonceau">Jean-Marc Dumonceau</name>
<affiliation wicri:level="1"><nlm:affiliation>Gedyt Endoscopy Center, Buenos Aires, Argentina.</nlm:affiliation>
<country xml:lang="fr">Argentine</country>
<wicri:regionArea>Gedyt Endoscopy Center, Buenos Aires</wicri:regionArea>
<wicri:noRegion>Buenos Aires</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Paspatis, Gregorios" sort="Paspatis, Gregorios" uniqKey="Paspatis G" first="Gregorios" last="Paspatis">Gregorios Paspatis</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Gastroenterology, Benizelion General Hospital, Heraklion, Crete, Greece.</nlm:affiliation>
<country xml:lang="fr">Grèce</country>
<wicri:regionArea>Department of Gastroenterology, Benizelion General Hospital, Heraklion, Crete</wicri:regionArea>
<wicri:noRegion>Crete</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Jover, Rodrigo" sort="Jover, Rodrigo" uniqKey="Jover R" first="Rodrigo" last="Jover">Rodrigo Jover</name>
<affiliation wicri:level="1"><nlm:affiliation>Unidad de Gastroenterología, Servicio de Medicina Digestiva, Instituto de Investigación Sanitaria ISABIAL, Hospital General Universitario de Alicante, Alicante, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Unidad de Gastroenterología, Servicio de Medicina Digestiva, Instituto de Investigación Sanitaria ISABIAL, Hospital General Universitario de Alicante, Alicante</wicri:regionArea>
<wicri:noRegion>Alicante</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Langner, Cord" sort="Langner, Cord" uniqKey="Langner C" first="Cord" last="Langner">Cord Langner</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Pathology, Medical University of Graz, Graz, Austria.</nlm:affiliation>
<country xml:lang="fr">Autriche</country>
<wicri:regionArea>Department of Pathology, Medical University of Graz, Graz</wicri:regionArea>
<wicri:noRegion>Graz</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bronzwaer, Maxime" sort="Bronzwaer, Maxime" uniqKey="Bronzwaer M" first="Maxime" last="Bronzwaer">Maxime Bronzwaer</name>
<affiliation wicri:level="4"><nlm:affiliation>Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.</nlm:affiliation>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
<settlement type="city">Amsterdam</settlement>
</placeName>
<orgName type="university">Université d'Amsterdam</orgName>
</affiliation>
</author>
<author><name sortKey="Nalankilli, Kumanan" sort="Nalankilli, Kumanan" uniqKey="Nalankilli K" first="Kumanan" last="Nalankilli">Kumanan Nalankilli</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Endoscopic Services, Western Health, Melbourne, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Endoscopic Services, Western Health, Melbourne</wicri:regionArea>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Fockens, Paul" sort="Fockens, Paul" uniqKey="Fockens P" first="Paul" last="Fockens">Paul Fockens</name>
<affiliation wicri:level="4"><nlm:affiliation>Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.</nlm:affiliation>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
<settlement type="city">Amsterdam</settlement>
</placeName>
<orgName type="university">Université d'Amsterdam</orgName>
</affiliation>
</author>
<author><name sortKey="Hazzan, Rawi" sort="Hazzan, Rawi" uniqKey="Hazzan R" first="Rawi" last="Hazzan">Rawi Hazzan</name>
<affiliation wicri:level="1"><nlm:affiliation>Institute of Gastroenterology and Hepatology, Ha'Emek Medical Center, Afula, Israel and Rappaport Family Faculty of Medicine Technion-Israel Institute of Technology, Haifa, Israel.</nlm:affiliation>
<country xml:lang="fr">Israël</country>
<wicri:regionArea>Institute of Gastroenterology and Hepatology, Ha'Emek Medical Center, Afula, Israel and Rappaport Family Faculty of Medicine Technion-Israel Institute of Technology, Haifa</wicri:regionArea>
<wicri:noRegion>Haifa</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Gralnek, Ian M" sort="Gralnek, Ian M" uniqKey="Gralnek I" first="Ian M" last="Gralnek">Ian M. Gralnek</name>
<affiliation wicri:level="1"><nlm:affiliation>Institute of Gastroenterology and Hepatology, Ha'Emek Medical Center, Afula, Israel and Rappaport Family Faculty of Medicine Technion-Israel Institute of Technology, Haifa, Israel.</nlm:affiliation>
<country xml:lang="fr">Israël</country>
<wicri:regionArea>Institute of Gastroenterology and Hepatology, Ha'Emek Medical Center, Afula, Israel and Rappaport Family Faculty of Medicine Technion-Israel Institute of Technology, Haifa</wicri:regionArea>
<wicri:noRegion>Haifa</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Gschwantler, Michael" sort="Gschwantler, Michael" uniqKey="Gschwantler M" first="Michael" last="Gschwantler">Michael Gschwantler</name>
<affiliation><nlm:affiliation>Quality Assurance Working Group of the Austrian Society of Gastroenterology and Hepatology.</nlm:affiliation>
<wicri:noCountry code="no comma">Quality Assurance Working Group of the Austrian Society of Gastroenterology and Hepatology.</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Waldmann, Elisabeth" sort="Waldmann, Elisabeth" uniqKey="Waldmann E" first="Elisabeth" last="Waldmann">Elisabeth Waldmann</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</nlm:affiliation>
<country xml:lang="fr">Autriche</country>
<wicri:regionArea>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna</wicri:regionArea>
<wicri:noRegion>Medical University of Vienna</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Jeschek, Philip" sort="Jeschek, Philip" uniqKey="Jeschek P" first="Philip" last="Jeschek">Philip Jeschek</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</nlm:affiliation>
<country xml:lang="fr">Autriche</country>
<wicri:regionArea>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna</wicri:regionArea>
<wicri:noRegion>Medical University of Vienna</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Penz, Daniela" sort="Penz, Daniela" uniqKey="Penz D" first="Daniela" last="Penz">Daniela Penz</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</nlm:affiliation>
<country xml:lang="fr">Autriche</country>
<wicri:regionArea>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna</wicri:regionArea>
<wicri:noRegion>Medical University of Vienna</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Heresbach, Denis" sort="Heresbach, Denis" uniqKey="Heresbach D" first="Denis" last="Heresbach">Denis Heresbach</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Digestive Endoscopy, University Hospital, CHU Fort de France, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Digestive Endoscopy, University Hospital, CHU Fort de France</wicri:regionArea>
<wicri:noRegion>CHU Fort de France</wicri:noRegion>
<wicri:noRegion>CHU Fort de France</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Moons, Leon" sort="Moons, Leon" uniqKey="Moons L" first="Leon" last="Moons">Leon Moons</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands.</nlm:affiliation>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht</wicri:regionArea>
<placeName><settlement type="city">Utrecht</settlement>
<region nuts="2" type="province">Utrecht (province)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lemmers, Arnaud" sort="Lemmers, Arnaud" uniqKey="Lemmers A" first="Arnaud" last="Lemmers">Arnaud Lemmers</name>
<affiliation wicri:level="4"><nlm:affiliation>Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.</nlm:affiliation>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels</wicri:regionArea>
<placeName><settlement type="city">Bruxelles</settlement>
<region nuts="2">Région de Bruxelles-Capitale</region>
<settlement type="city">Bruxelles</settlement>
</placeName>
<orgName type="university">Université libre de Bruxelles</orgName>
</affiliation>
</author>
<author><name sortKey="Paraskeva, Konstantina" sort="Paraskeva, Konstantina" uniqKey="Paraskeva K" first="Konstantina" last="Paraskeva">Konstantina Paraskeva</name>
<affiliation wicri:level="3"><nlm:affiliation>Konstantopoulio General Hospital, Athens, Greece.</nlm:affiliation>
<country xml:lang="fr">Grèce</country>
<wicri:regionArea>Konstantopoulio General Hospital, Athens</wicri:regionArea>
<placeName><settlement type="city">Athènes</settlement>
<region nuts="2" type="region">Attique (région)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Pohl, Juergen" sort="Pohl, Juergen" uniqKey="Pohl J" first="Juergen" last="Pohl">Juergen Pohl</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Gastroenterology, Asklepios Klinik Altona, Hamburg, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Gastroenterology, Asklepios Klinik Altona, Hamburg</wicri:regionArea>
<placeName><settlement type="city">Hambourg</settlement>
<region type="land" nuts="2">Hambourg</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ponchon, Thierry" sort="Ponchon, Thierry" uniqKey="Ponchon T" first="Thierry" last="Ponchon">Thierry Ponchon</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Endoscopy and Gastroenterology, Edouard Herriot Hospital, Lyon, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Endoscopy and Gastroenterology, Edouard Herriot Hospital, Lyon</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Rhône-Alpes</region>
<settlement type="city">Lyon</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Regula, Jaroslaw" sort="Regula, Jaroslaw" uniqKey="Regula J" first="Jaroslaw" last="Regula">Jaroslaw Regula</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Gastroenterology, Maria Sklodowska-Curie Memorial CancerCenter and Medical Centre for Postgraduate Education, Warsaw, Poland.</nlm:affiliation>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Department of Gastroenterology, Maria Sklodowska-Curie Memorial CancerCenter and Medical Centre for Postgraduate Education, Warsaw</wicri:regionArea>
<wicri:noRegion>Warsaw</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Repici, Alessandro" sort="Repici, Alessandro" uniqKey="Repici A" first="Alessandro" last="Repici">Alessandro Repici</name>
<affiliation wicri:level="3"><nlm:affiliation>Humanitas Research Hospital, Humanitas University, Rozzano, Milan, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Humanitas Research Hospital, Humanitas University, Rozzano, Milan</wicri:regionArea>
<placeName><settlement type="city">Milan</settlement>
<region nuts="2">Lombardie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Rutter, Matthew D" sort="Rutter, Matthew D" uniqKey="Rutter M" first="Matthew D" last="Rutter">Matthew D. Rutter</name>
<affiliation wicri:level="1"><nlm:affiliation>School of Medicine, Pharmacy and Health, Durham University, Durham, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>School of Medicine, Pharmacy and Health, Durham University, Durham</wicri:regionArea>
<wicri:noRegion>Durham</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Burgess, Nicholas G" sort="Burgess, Nicholas G" uniqKey="Burgess N" first="Nicholas G" last="Burgess">Nicholas G. Burgess</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney</wicri:regionArea>
<placeName><settlement type="city">Sydney</settlement>
<region type="état">Nouvelle-Galles du Sud</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Bourke, Michael J" sort="Bourke, Michael J" uniqKey="Bourke M" first="Michael J" last="Bourke">Michael J. Bourke</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney</wicri:regionArea>
<placeName><settlement type="city">Sydney</settlement>
<region type="état">Nouvelle-Galles du Sud</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">Endoscopy</title>
<idno type="eISSN">1438-8812</idno>
<imprint><date when="2017" type="published">2017</date>
</imprint>
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<term>Adenomatous Polyps (surgery)</term>
<term>Algorithms</term>
<term>Colon (diagnostic imaging)</term>
<term>Colon (pathology)</term>
<term>Colon (surgery)</term>
<term>Colonoscopy (instrumentation)</term>
<term>Colonoscopy (methods)</term>
<term>Colonoscopy (standards)</term>
<term>Colorectal Neoplasms (diagnostic imaging)</term>
<term>Colorectal Neoplasms (pathology)</term>
<term>Colorectal Neoplasms (surgery)</term>
<term>Endoscopic Mucosal Resection (instrumentation)</term>
<term>Endoscopic Mucosal Resection (methods)</term>
<term>Endoscopic Mucosal Resection (standards)</term>
<term>Humans</term>
<term>Intestinal Polyps (diagnostic imaging)</term>
<term>Intestinal Polyps (pathology)</term>
<term>Intestinal Polyps (surgery)</term>
<term>Postoperative Complications (diagnosis)</term>
<term>Postoperative Complications (etiology)</term>
<term>Postoperative Complications (prevention & control)</term>
<term>Rectum (diagnostic imaging)</term>
<term>Rectum (pathology)</term>
<term>Rectum (surgery)</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Algorithmes</term>
<term>Coloscopie ()</term>
<term>Coloscopie (instrumentation)</term>
<term>Coloscopie (normes)</term>
<term>Complications postopératoires ()</term>
<term>Complications postopératoires (diagnostic)</term>
<term>Complications postopératoires (étiologie)</term>
<term>Côlon ()</term>
<term>Côlon (anatomopathologie)</term>
<term>Côlon (imagerie diagnostique)</term>
<term>Humains</term>
<term>Mucosectomie endoscopique ()</term>
<term>Mucosectomie endoscopique (instrumentation)</term>
<term>Mucosectomie endoscopique (normes)</term>
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<front><div type="abstract" xml:lang="en">1 ESGE recommends cold snare polypectomy (CSP) as the preferred technique for removal of diminutive polyps (size ≤ 5 mm). This technique has high rates of complete resection, adequate tissue sampling for histology, and low complication rates. (High quality evidence, strong recommendation.) 2 ESGE suggests CSP for sessile polyps 6 - 9 mm in size because of its superior safety profile, although evidence comparing efficacy with hot snare polypectomy (HSP) is lacking. (Moderate quality evidence, weak recommendation.) 3 ESGE suggests HSP (with or without submucosal injection) for removal of sessile polyps 10 - 19 mm in size. In most cases deep thermal injury is a potential risk and thus submucosal injection prior to HSP should be considered. (Low quality evidence, strong recommendation.) 4 ESGE recommends HSP for pedunculated polyps. To prevent bleeding in pedunculated colorectal polyps with head ≥ 20 mm or a stalk ≥ 10 mm in diameter, ESGE recommends pretreatment of the stalk with injection of dilute adrenaline and/or mechanical hemostasis. (Moderate quality evidence, strong recommendation.) 5 ESGE recommends that the goals of endoscopic mucosal resection (EMR) are to achieve a completely snare-resected lesion in the safest minimum number of pieces, with adequate margins and without need for adjunctive ablative techniques. (Low quality evidence; strong recommendation.) 6 ESGE recommends careful lesion assessment prior to EMR to identify features suggestive of poor outcome. Features associated with incomplete resection or recurrence include lesion size > 40 mm, ileocecal valve location, prior failed attempts at resection, and size, morphology, site, and access (SMSA) level 4. (Moderate quality evidence; strong recommendation.) 7 For intraprocedural bleeding, ESGE recommends endoscopic coagulation (snare-tip soft coagulation or coagulating forceps) or mechanical therapy, with or without the combined use of dilute adrenaline injection. (Low quality evidence, strong recommendation.)An algorithm of polypectomy recommendations according to shape and size of polyps is given (Fig. 1).</div>
</front>
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