Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.
Identifieur interne : 000F42 ( PubMed/Corpus ); précédent : 000F41; suivant : 000F43Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.
Auteurs : Monika Ferlitsch ; Alan Moss ; Cesare Hassan ; Pradeep Bhandari ; Jean-Marc Dumonceau ; Gregorios Paspatis ; Rodrigo Jover ; Cord Langner ; Maxime Bronzwaer ; Kumanan Nalankilli ; Paul Fockens ; Rawi Hazzan ; Ian M. Gralnek ; Michael Gschwantler ; Elisabeth Waldmann ; Philip Jeschek ; Daniela Penz ; Denis Heresbach ; Leon Moons ; Arnaud Lemmers ; Konstantina Paraskeva ; Juergen Pohl ; Thierry Ponchon ; Jaroslaw Regula ; Alessandro Repici ; Matthew D. Rutter ; Nicholas G. Burgess ; Michael J. BourkeSource :
- Endoscopy [ 1438-8812 ] ; 2017.
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
Links to Exploration step
pubmed:28212588Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.</title><author><name sortKey="Ferlitsch, Monika" sort="Ferlitsch, Monika" uniqKey="Ferlitsch M" first="Monika" last="Ferlitsch">Monika Ferlitsch</name><affiliation><nlm:affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Moss, Alan" sort="Moss, Alan" uniqKey="Moss A" first="Alan" last="Moss">Alan Moss</name><affiliation><nlm:affiliation>Department of Endoscopic Services, Western Health, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Hassan, Cesare" sort="Hassan, Cesare" uniqKey="Hassan C" first="Cesare" last="Hassan">Cesare Hassan</name><affiliation><nlm:affiliation>Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Bhandari, Pradeep" sort="Bhandari, Pradeep" uniqKey="Bhandari P" first="Pradeep" last="Bhandari">Pradeep Bhandari</name><affiliation><nlm:affiliation>Solent Centre for Digestive Diseases, Queen Alexandra Hospital, Portsmouth, UK.</nlm:affiliation></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><nlm:affiliation>Gedyt Endoscopy Center, Buenos Aires, Argentina.</nlm:affiliation></affiliation></author><author><name sortKey="Paspatis, Gregorios" sort="Paspatis, Gregorios" uniqKey="Paspatis G" first="Gregorios" last="Paspatis">Gregorios Paspatis</name><affiliation><nlm:affiliation>Department of Gastroenterology, Benizelion General Hospital, Heraklion, Crete, Greece.</nlm:affiliation></affiliation></author><author><name sortKey="Jover, Rodrigo" sort="Jover, Rodrigo" uniqKey="Jover R" first="Rodrigo" last="Jover">Rodrigo Jover</name><affiliation><nlm:affiliation>Unidad de Gastroenterología, Servicio de Medicina Digestiva, Instituto de Investigación Sanitaria ISABIAL, Hospital General Universitario de Alicante, Alicante, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Langner, Cord" sort="Langner, Cord" uniqKey="Langner C" first="Cord" last="Langner">Cord Langner</name><affiliation><nlm:affiliation>Department of Pathology, Medical University of Graz, Graz, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Bronzwaer, Maxime" sort="Bronzwaer, Maxime" uniqKey="Bronzwaer M" first="Maxime" last="Bronzwaer">Maxime Bronzwaer</name><affiliation><nlm:affiliation>Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Nalankilli, Kumanan" sort="Nalankilli, Kumanan" uniqKey="Nalankilli K" first="Kumanan" last="Nalankilli">Kumanan Nalankilli</name><affiliation><nlm:affiliation>Department of Endoscopic Services, Western Health, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Fockens, Paul" sort="Fockens, Paul" uniqKey="Fockens P" first="Paul" last="Fockens">Paul Fockens</name><affiliation><nlm:affiliation>Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Hazzan, Rawi" sort="Hazzan, Rawi" uniqKey="Hazzan R" first="Rawi" last="Hazzan">Rawi Hazzan</name><affiliation><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></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><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></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></affiliation></author><author><name sortKey="Waldmann, Elisabeth" sort="Waldmann, Elisabeth" uniqKey="Waldmann E" first="Elisabeth" last="Waldmann">Elisabeth Waldmann</name><affiliation><nlm:affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Jeschek, Philip" sort="Jeschek, Philip" uniqKey="Jeschek P" first="Philip" last="Jeschek">Philip Jeschek</name><affiliation><nlm:affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Penz, Daniela" sort="Penz, Daniela" uniqKey="Penz D" first="Daniela" last="Penz">Daniela Penz</name><affiliation><nlm:affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Heresbach, Denis" sort="Heresbach, Denis" uniqKey="Heresbach D" first="Denis" last="Heresbach">Denis Heresbach</name><affiliation><nlm:affiliation>Department of Digestive Endoscopy, University Hospital, CHU Fort de France, France.</nlm:affiliation></affiliation></author><author><name sortKey="Moons, Leon" sort="Moons, Leon" uniqKey="Moons L" first="Leon" last="Moons">Leon Moons</name><affiliation><nlm:affiliation>Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Lemmers, Arnaud" sort="Lemmers, Arnaud" uniqKey="Lemmers A" first="Arnaud" last="Lemmers">Arnaud Lemmers</name><affiliation><nlm:affiliation>Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Paraskeva, Konstantina" sort="Paraskeva, Konstantina" uniqKey="Paraskeva K" first="Konstantina" last="Paraskeva">Konstantina Paraskeva</name><affiliation><nlm:affiliation>Konstantopoulio General Hospital, Athens, Greece.</nlm:affiliation></affiliation></author><author><name sortKey="Pohl, Juergen" sort="Pohl, Juergen" uniqKey="Pohl J" first="Juergen" last="Pohl">Juergen Pohl</name><affiliation><nlm:affiliation>Department of Gastroenterology, Asklepios Klinik Altona, Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Ponchon, Thierry" sort="Ponchon, Thierry" uniqKey="Ponchon T" first="Thierry" last="Ponchon">Thierry Ponchon</name><affiliation><nlm:affiliation>Department of Endoscopy and Gastroenterology, Edouard Herriot Hospital, Lyon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Regula, Jaroslaw" sort="Regula, Jaroslaw" uniqKey="Regula J" first="Jaroslaw" last="Regula">Jaroslaw Regula</name><affiliation><nlm:affiliation>Department of Gastroenterology, Maria Sklodowska-Curie Memorial CancerCenter and Medical Centre for Postgraduate Education, Warsaw, Poland.</nlm:affiliation></affiliation></author><author><name sortKey="Repici, Alessandro" sort="Repici, Alessandro" uniqKey="Repici A" first="Alessandro" last="Repici">Alessandro Repici</name><affiliation><nlm:affiliation>Humanitas Research Hospital, Humanitas University, Rozzano, Milan, Italy.</nlm:affiliation></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><nlm:affiliation>School of Medicine, Pharmacy and Health, Durham University, Durham, UK.</nlm:affiliation></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><nlm:affiliation>Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia.</nlm:affiliation></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><nlm:affiliation>Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:28212588</idno><idno type="pmid">28212588</idno><idno type="doi">10.1055/s-0043-102569</idno><idno type="wicri:Area/PubMed/Corpus">000F42</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000F42</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.</title><author><name sortKey="Ferlitsch, Monika" sort="Ferlitsch, Monika" uniqKey="Ferlitsch M" first="Monika" last="Ferlitsch">Monika Ferlitsch</name><affiliation><nlm:affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Moss, Alan" sort="Moss, Alan" uniqKey="Moss A" first="Alan" last="Moss">Alan Moss</name><affiliation><nlm:affiliation>Department of Endoscopic Services, Western Health, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Hassan, Cesare" sort="Hassan, Cesare" uniqKey="Hassan C" first="Cesare" last="Hassan">Cesare Hassan</name><affiliation><nlm:affiliation>Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Bhandari, Pradeep" sort="Bhandari, Pradeep" uniqKey="Bhandari P" first="Pradeep" last="Bhandari">Pradeep Bhandari</name><affiliation><nlm:affiliation>Solent Centre for Digestive Diseases, Queen Alexandra Hospital, Portsmouth, UK.</nlm:affiliation></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><nlm:affiliation>Gedyt Endoscopy Center, Buenos Aires, Argentina.</nlm:affiliation></affiliation></author><author><name sortKey="Paspatis, Gregorios" sort="Paspatis, Gregorios" uniqKey="Paspatis G" first="Gregorios" last="Paspatis">Gregorios Paspatis</name><affiliation><nlm:affiliation>Department of Gastroenterology, Benizelion General Hospital, Heraklion, Crete, Greece.</nlm:affiliation></affiliation></author><author><name sortKey="Jover, Rodrigo" sort="Jover, Rodrigo" uniqKey="Jover R" first="Rodrigo" last="Jover">Rodrigo Jover</name><affiliation><nlm:affiliation>Unidad de Gastroenterología, Servicio de Medicina Digestiva, Instituto de Investigación Sanitaria ISABIAL, Hospital General Universitario de Alicante, Alicante, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Langner, Cord" sort="Langner, Cord" uniqKey="Langner C" first="Cord" last="Langner">Cord Langner</name><affiliation><nlm:affiliation>Department of Pathology, Medical University of Graz, Graz, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Bronzwaer, Maxime" sort="Bronzwaer, Maxime" uniqKey="Bronzwaer M" first="Maxime" last="Bronzwaer">Maxime Bronzwaer</name><affiliation><nlm:affiliation>Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Nalankilli, Kumanan" sort="Nalankilli, Kumanan" uniqKey="Nalankilli K" first="Kumanan" last="Nalankilli">Kumanan Nalankilli</name><affiliation><nlm:affiliation>Department of Endoscopic Services, Western Health, Melbourne, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Fockens, Paul" sort="Fockens, Paul" uniqKey="Fockens P" first="Paul" last="Fockens">Paul Fockens</name><affiliation><nlm:affiliation>Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Hazzan, Rawi" sort="Hazzan, Rawi" uniqKey="Hazzan R" first="Rawi" last="Hazzan">Rawi Hazzan</name><affiliation><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></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><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></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></affiliation></author><author><name sortKey="Waldmann, Elisabeth" sort="Waldmann, Elisabeth" uniqKey="Waldmann E" first="Elisabeth" last="Waldmann">Elisabeth Waldmann</name><affiliation><nlm:affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Jeschek, Philip" sort="Jeschek, Philip" uniqKey="Jeschek P" first="Philip" last="Jeschek">Philip Jeschek</name><affiliation><nlm:affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Penz, Daniela" sort="Penz, Daniela" uniqKey="Penz D" first="Daniela" last="Penz">Daniela Penz</name><affiliation><nlm:affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</nlm:affiliation></affiliation></author><author><name sortKey="Heresbach, Denis" sort="Heresbach, Denis" uniqKey="Heresbach D" first="Denis" last="Heresbach">Denis Heresbach</name><affiliation><nlm:affiliation>Department of Digestive Endoscopy, University Hospital, CHU Fort de France, France.</nlm:affiliation></affiliation></author><author><name sortKey="Moons, Leon" sort="Moons, Leon" uniqKey="Moons L" first="Leon" last="Moons">Leon Moons</name><affiliation><nlm:affiliation>Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Lemmers, Arnaud" sort="Lemmers, Arnaud" uniqKey="Lemmers A" first="Arnaud" last="Lemmers">Arnaud Lemmers</name><affiliation><nlm:affiliation>Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.</nlm:affiliation></affiliation></author><author><name sortKey="Paraskeva, Konstantina" sort="Paraskeva, Konstantina" uniqKey="Paraskeva K" first="Konstantina" last="Paraskeva">Konstantina Paraskeva</name><affiliation><nlm:affiliation>Konstantopoulio General Hospital, Athens, Greece.</nlm:affiliation></affiliation></author><author><name sortKey="Pohl, Juergen" sort="Pohl, Juergen" uniqKey="Pohl J" first="Juergen" last="Pohl">Juergen Pohl</name><affiliation><nlm:affiliation>Department of Gastroenterology, Asklepios Klinik Altona, Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Ponchon, Thierry" sort="Ponchon, Thierry" uniqKey="Ponchon T" first="Thierry" last="Ponchon">Thierry Ponchon</name><affiliation><nlm:affiliation>Department of Endoscopy and Gastroenterology, Edouard Herriot Hospital, Lyon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Regula, Jaroslaw" sort="Regula, Jaroslaw" uniqKey="Regula J" first="Jaroslaw" last="Regula">Jaroslaw Regula</name><affiliation><nlm:affiliation>Department of Gastroenterology, Maria Sklodowska-Curie Memorial CancerCenter and Medical Centre for Postgraduate Education, Warsaw, Poland.</nlm:affiliation></affiliation></author><author><name sortKey="Repici, Alessandro" sort="Repici, Alessandro" uniqKey="Repici A" first="Alessandro" last="Repici">Alessandro Repici</name><affiliation><nlm:affiliation>Humanitas Research Hospital, Humanitas University, Rozzano, Milan, Italy.</nlm:affiliation></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><nlm:affiliation>School of Medicine, Pharmacy and Health, Durham University, Durham, UK.</nlm:affiliation></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><nlm:affiliation>Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia.</nlm:affiliation></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><nlm:affiliation>Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Endoscopy</title><idno type="eISSN">1438-8812</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adenomatous Polyps (diagnostic imaging)</term><term>Adenomatous Polyps (pathology)</term><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></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Adenomatous Polyps</term><term>Colon</term><term>Colorectal Neoplasms</term><term>Intestinal Polyps</term><term>Rectum</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Colonoscopy</term><term>Endoscopic Mucosal Resection</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Colonoscopy</term><term>Endoscopic Mucosal Resection</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Adenomatous Polyps</term><term>Colon</term><term>Colorectal Neoplasms</term><term>Intestinal Polyps</term><term>Rectum</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Colonoscopy</term><term>Endoscopic Mucosal Resection</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Adenomatous Polyps</term><term>Colon</term><term>Colorectal Neoplasms</term><term>Intestinal Polyps</term><term>Rectum</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Algorithms</term><term>Humans</term></keywords></textClass></profileDesc></teiHeader><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></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28212588</PMID><DateCreated><Year>2017</Year><Month>02</Month><Day>17</Day></DateCreated><DateCompleted><Year>2017</Year><Month>06</Month><Day>26</Day></DateCompleted><DateRevised><Year>2017</Year><Month>06</Month><Day>26</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1438-8812</ISSN><JournalIssue CitedMedium="Internet"><Volume>49</Volume><Issue>3</Issue><PubDate><Year>2017</Year><Month>Mar</Month></PubDate></JournalIssue><Title>Endoscopy</Title><ISOAbbreviation>Endoscopy</ISOAbbreviation></Journal><ArticleTitle>Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.</ArticleTitle><Pagination><MedlinePgn>270-297</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1055/s-0043-102569</ELocationID><Abstract><AbstractText>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).</AbstractText><CopyrightInformation>© Georg Thieme Verlag KG Stuttgart · New York.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ferlitsch</LastName><ForeName>Monika</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Quality Assurance Working Group of the Austrian Society of Gastroenterology and Hepatology.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Moss</LastName><ForeName>Alan</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Endoscopic Services, Western Health, Melbourne, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medicine, Melbourne Medical School Western Precinct, The University of Melbourne, St. Albans, Victoria, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hassan</LastName><ForeName>Cesare</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bhandari</LastName><ForeName>Pradeep</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Solent Centre for Digestive Diseases, Queen Alexandra Hospital, Portsmouth, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dumonceau</LastName><ForeName>Jean-Marc</ForeName><Initials>JM</Initials><AffiliationInfo><Affiliation>Gedyt Endoscopy Center, Buenos Aires, Argentina.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Paspatis</LastName><ForeName>Gregorios</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Gastroenterology, Benizelion General Hospital, Heraklion, Crete, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jover</LastName><ForeName>Rodrigo</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Unidad de Gastroenterología, Servicio de Medicina Digestiva, Instituto de Investigación Sanitaria ISABIAL, Hospital General Universitario de Alicante, Alicante, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Langner</LastName><ForeName>Cord</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Pathology, Medical University of Graz, Graz, Austria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bronzwaer</LastName><ForeName>Maxime</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nalankilli</LastName><ForeName>Kumanan</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Endoscopic Services, Western Health, Melbourne, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medicine, Melbourne Medical School Western Precinct, The University of Melbourne, St. Albans, Victoria, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fockens</LastName><ForeName>Paul</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hazzan</LastName><ForeName>Rawi</ForeName><Initials>R</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gralnek</LastName><ForeName>Ian M</ForeName><Initials>IM</Initials><AffiliationInfo><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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gschwantler</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Quality Assurance Working Group of the Austrian Society of Gastroenterology and Hepatology.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Waldmann</LastName><ForeName>Elisabeth</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Quality Assurance Working Group of the Austrian Society of Gastroenterology and Hepatology.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jeschek</LastName><ForeName>Philip</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Quality Assurance Working Group of the Austrian Society of Gastroenterology and Hepatology.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Penz</LastName><ForeName>Daniela</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Austria.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Quality Assurance Working Group of the Austrian Society of Gastroenterology and Hepatology.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Heresbach</LastName><ForeName>Denis</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Digestive Endoscopy, University Hospital, CHU Fort de France, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Moons</LastName><ForeName>Leon</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lemmers</LastName><ForeName>Arnaud</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Paraskeva</LastName><ForeName>Konstantina</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Konstantopoulio General Hospital, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pohl</LastName><ForeName>Juergen</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Gastroenterology, Asklepios Klinik Altona, Hamburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ponchon</LastName><ForeName>Thierry</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Endoscopy and Gastroenterology, Edouard Herriot Hospital, Lyon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Regula</LastName><ForeName>Jaroslaw</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Gastroenterology, Maria Sklodowska-Curie Memorial CancerCenter and Medical Centre for Postgraduate Education, Warsaw, Poland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Repici</LastName><ForeName>Alessandro</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Humanitas Research Hospital, Humanitas University, Rozzano, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rutter</LastName><ForeName>Matthew D</ForeName><Initials>MD</Initials><AffiliationInfo><Affiliation>School of Medicine, Pharmacy and Health, Durham University, Durham, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Burgess</LastName><ForeName>Nicholas G</ForeName><Initials>NG</Initials><AffiliationInfo><Affiliation>Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>University of Sydney, Sydney, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bourke</LastName><ForeName>Michael J</ForeName><Initials>MJ</Initials><AffiliationInfo><Affiliation>Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>University of Sydney, Sydney, Australia.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D017065">Practice Guideline</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>02</Month><Day>17</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Endoscopy</MedlineTA><NlmUniqueID>0215166</NlmUniqueID><ISSNLinking>0013-726X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D018256" MajorTopicYN="N">Adenomatous Polyps</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000465" MajorTopicYN="N">Algorithms</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003106" MajorTopicYN="N">Colon</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003113" MajorTopicYN="N">Colonoscopy</DescriptorName><QualifierName UI="Q000295" MajorTopicYN="N">instrumentation</QualifierName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015179" MajorTopicYN="N">Colorectal Neoplasms</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000069916" MajorTopicYN="N">Endoscopic Mucosal Resection</DescriptorName><QualifierName UI="Q000295" MajorTopicYN="N">instrumentation</QualifierName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007417" MajorTopicYN="N">Intestinal Polyps</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011183" MajorTopicYN="N">Postoperative Complications</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012007" MajorTopicYN="N">Rectum</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>2</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>6</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>2</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28212588</ArticleId><ArticleId IdType="doi">10.1055/s-0043-102569</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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