“Nonlifting colon polyps”, una nuova categoria di “polipo difficile”


Marco Bisello, Tina Scibelli, Francesco Azzolini, Dario Esposito


Screening protocols have allowed the early detection of many colorectal cancers at an early stage. As a result, endoscopists have developed many techniques to allow the resection of these lesions, with a low recurrence rate and a low complication incidence. European Society of Gastrointestinal Endoscopy (ESGE) guidelines suggest piecemeal Endoscopic mucosal resection (EMR) for many lesions presenting no signs of deep invasion, however it could be argued that that clinicians should aim for en-bloc resection as frequently as possible. It is worth noting that the resection of some lesions are particularly challenging if the separation of planes is unclear due to fibrosis. This paper aims to describe the different techniques for full-thickness resection, namely the non-exposed and exposed techniques. The non-exposed technique is performed by placing a clip grasping all the layers of the intestinal wall at the base of the lesion before the resection. The latter is performed by resecting the lesion, creating an opening in the peritoneum, and then closing the opening.

Bisello M, Scibelli T, Azzolini F, et al. “Nonlifting colon polyps”, una nuova categoria di “polipo difficile” – Trattamento endoscopico full-thickness resection (ftr) con tecnica esposta e non esposta. GIED. 2023 Dec;vol.4:17-22