Gastroenterology and Hepatology

Polypectomy

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Size >2cm should do piecemeal. Unlikely single attempt snare will succeed
Elevate with injection before removal
Be careful over caecum

Consider surgery if
  1. >1/3 circumference
  2. >2 haustral folds
  3. Base of appendix

Signs of malignancy:
  1. Firm in consistency
  2. Ulcerateed
  3. Friable
  4. Adherence to underlying structure and hard to elevate with injection


Postadenoma resection

1-2 tubular adenomas of <1 cm 5-10 y interval

3-10 adenomas or adenoma with villous features, ≥1 cm or with HGD 3 y interval

>10 adenomas <3 y interval

Sessile adenoma of ≥2 cm, removed piecemeal 2-6 m interval

edited 12th July 2010