ASGE Advanced Endoscopic Lesion Resection Course | November 2022-The Complex Polyp: What to Resect and When to Pass on Resection

Video Transcription

Video Summary

In this video, Dr. Offman discusses the importance of determining when to resect polyps for gastroenterology patients. He explains that while the removal of polyps is important, it is equally important to know when not to remove them to avoid potential complications. He discusses the risk of tumor cells spreading to the lymph nodes and the need to take this into consideration when deciding whether to perform resection or refer the patient for surgery. Dr. Offman explains the Paris classification system, which categorizes GI lesions based on their morphology, and the importance of understanding surface patterns and predicting lymphovascular invasion and lymph node metastasis. He also discusses the Haggitt classification for bedunculated polyps and the SM classification for submucosal invasion. Dr. Offman emphasizes the need for guidelines in the US to differentiate when to perform EMR or ESD procedures, and highlights the European and Korean guidelines for polyp management. He also discusses the potential for endoscopic removal of lesions located in the appendix and IC valve, challenging previous views that these locations always require surgical resection. Dr. Offman concludes by encouraging physicians to commit to their initial impressions of polyps and to use classification systems to guide their decision-making.

Asset Subtitle

Mohammed Othman, MD

Keywords

resect polyps

lymph nodes

Paris classification

GI lesions

lymphovascular invasion

EMR procedures

endoscopic removal