Diagnosis and endoscopic management of colorectal polyps

The diagnosis of colonic polyps is currently established with virtual chromoendoscopy and described using the NICE or JNET classification. Subsequent management comprises a large variety of techniques. The most commonly used endoscopic procedure is snare polypectomy. According to guidelines, polyps up to approximately 10mm should usually be removed with a cold snare, for larger polyps a hot snare is normally used. In principle, the goal of all endoscopic techniques is complete removal of all detected detected lesions. Post-polypectomy colonoscopy surveillance is based on histological findings, the number and size of polyps, and the patient's risk profile. However, the limitations of endoscopic removal techniques must be observed; e.g., if a polyp does not meet the criteria for safe complete endoscopic removal, surgical resection should be considered.