“...are you happy having your own polyps thrown out?”

Is ‘Resect and Discard’ Gaining Acceptance?

by Caroline Helwick

Guidelines are in place because of the need to precisely know the pathology of colorectal lesions and to be able to identify those containing invasive carcinoma, which often is not obvious, because size is not a perfect indicator, Dr. Riddell pointed out. There are also rare instances when the unexpected occurs.

“There are less common things that can easily be missed by this technique,” Dr. Riddell said, for example, neuroendocrine polyps in the rectum, metastatic carcinomas presenting as small polyps, and lymphomas and melanomas in the gastrointestinal tract.

“Can we assume that all these variants really do get picked up and sent to pathology?” he asked. “Throwing these away is not without its consequences.”

Dr. Riddell also offered a few “intangibles,” asking the gastroenterologists in attendance, “Are you comfortable with never knowing what you are dealing with? And are you happy having your own polyps thrown out?”