Tratamiento endoscópico de lesiones colorrectales grandes

Colorectal cancer has increased its incidence in some countries of South America and Central America. The knowledge about colorectal lesions and the definition of characteristics with more potential for malignancy has provided a better follow-up and treatment of these lesions. One of the characteristics that require a special evaluation is the large lesions (≥ 20 mm). When a colorectal lesion greater than 20 mm is detected, it should be considered as having a high potential for malignancy, since it presents a great potential for invasion of submucosa and / or lymph nodes, in addition to a risk of containing carcinoma up to 50%. The advent of new endoscopic techniques allowed the resection of lesions that until recently could not be treated in this way. Endoscopic mucosal resection (EMR) is one of the effective techniques for the treatment of these tumors, with high percentages of success and fewer complications. Endoscopic submucosal dissection (ESD) is another technique that allows the treatment of lesions larger than 20 mm. This procedure has more complication rates and a greater learning curve, but allows the extraction of tumors with success in up to 96% of cases. Therefore, with a quality morphological evaluation by the endoscopic techniques available today, large lesions can be treated by endoscopy.