Topic Highlight
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World J Gastroenterol. Sep 28, 2014; 20(36): 13027-13034
Published online Sep 28, 2014. doi: 10.3748/wjg.v20.i36.13027
Improving quality measures in colonoscopy and its therapeutic intervention
Akira Horiuchi, Naoki Tanaka
Akira Horiuchi, Digestive Disease Center, Showa Inan General Hospital, Komagane 399-4117, Japan
Naoki Tanaka, Laboratory of Metabolism, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, United States
Author contributions: Horiuchi A and Tanaka N acquired the data, analyzed and interpreted the data, revised the manuscript and gave final approval of the version to be published.
Correspondence to: Akira Horiuchi, MD, Digestive Disease Center, Showa Inan General Hospital, 3230 Akaho, Komagane 399-4117, Japan. horiuchi.akira@sihp.jp
Telephone: +81-265-822121 Fax: +81-265-822118
Received: October 24, 2013
Revised: January 14, 2014
Accepted: April 30, 2014
Published online: September 28, 2014
Processing time: 342 Days and 8.6 Hours
Core Tip

Core tip: Achieving appropriate bowel preparation and proper luminal distention for endoscopic mucosal imaging remains the key step enabling the endoscopist to detect colorectal neoplasia and predict polyp pathology. Success improves with experience and feedback. In this review we discuss the impact of high-definition colonoscopy, hood-assisted colonoscopy, and dye-based and virtual chromoendoscopy on colorectal polyp detection and prediction. Colonoscopic polypectomy is a continuously evolving therapy and has the potential to further reduce the risk of colorectal cancer. We propose that optimal polypectomy techniques for nonpedunculated polyps should be primarily based on polyp size, and these include cold forceps polypectomy (1-3 mm), cold snare polypectomy (4-10 mm), conventional polypectomy (7-14 mm), and endoscopic mucosal resection (EMR) (15-20 mm). For polyps larger than 21 mm, piecemeal EMR or endoscopic submucosal dissection is preferred.