Clinical Challenges in Colorectal Surgery: Management of Advanced and Malignant Polyps

Behind The Knife: The Surgery Podcast

Education, Science, Health & Fitness, Medicine

4.8 • 1.4K Ratings

🗓️ 8 April 2024

⏱️ 35 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Join Drs. Galandiuk, Bolshinsky, Kavalukas, and Simon as they discuss Management of Advanced and Malignant Polyps. Come with us as we navigate through sessile serrated lesions, pathology reports, and rectal polyp nuances.

Hosts:
- Susan Galandiuk, University of Louisville, Louisville, Kentucky, @DCREdInChief
- Vladimir Bolshinsky, Peninsula Health, Victoria, Australia, @bolshinskyv
- Sandy Kavalukas, University of Louisville, Louisville, Kentucky, @sandykava
- Hillary Simon, University of Louisville, Louisville, Kentucky, @HillaryLSimon

Producer:
- Manasa Sunkara MS3, University of Louisville, Louisville, Kentucky, @manasasunkara12

Learning objectives:
- Review colorectal cancer screening for the average risk patient.
- Understand what a malignant polyp is defined as and management strategies.
- Discuss the pathology review and re-review processes.

References:
- Church J, et al. Keeping the Cecum Clean: A Randomized, Prospective, Placebo-Controlled Trial of Loperamide as Part of Preparation for Colonoscopy. Diseases of the Colon & Rectum 56(1):p 120-125, January 2013.
https://pubmed.ncbi.nlm.nih.gov/23222289/
- Fan C, et al. Management of Serrated Polyps of the Colon. Curr Treat Options Gastroenterol 16(1):182-202, March 2018.
https://pubmed.ncbi.nlm.nih.gov/29445907/
- Gupta S, et al. Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer. The American Journal of Gastroenterology 115(3): 415-434, March 2020.
https://pubmed.ncbi.nlm.nih.gov/32039982/
- Hyman N, Waye JD. Endoscopic four quadrant tattoo for the identification of colonic lesions at surgery. Gastrointest Endosc 37:56–58, 1991.
https://pubmed.ncbi.nlm.nih.gov/1706283/
- Kaltenbach T, et al. Endoscopic Removal of Colorectal Lesions—Recommendations by the US Multi-Society Task Force on Colorectal Cancer. Gastrointestinal Endoscopy 91(3): 486-519, March 2020.
https://pubmed.ncbi.nlm.nih.gov/32067745/
- Keswani R, et al. AGA Clinical Practice Update on Strategies to Improve Quality of Screening and Surveillance Colonoscopy: Expert Review. Gastroenterology, 161(2): 701 – 711, Aug 2021.
https://pubmed.ncbi.nlm.nih.gov/34334168/
- Shaukat A, et al. Endoscopic Recognition and Management Strategies for Malignant Colorectal Polyps: Recommendations of the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology, 159(5): 1916 - 1934.e2, Nov 2020.
https://pubmed.ncbi.nlm.nih.gov/33159840/

Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

If you liked this episode, check out our recent epispdes here: https://app.behindtheknife.org/listen

Transcript

Click on a timestamp to play from that location

0:00.0	Behind the surgery podcast, relevant and engaging content designed to help you dominate the day.
0:13.0	Welcome back to another episode of clinical challenges in colorectal surgery with Dr.
0:26.8	Galandiat, Cabalucus, Bolshinsky, and Simon.
0:30.1	Today we'll be discussing several cases surrounding the management of advanced and malignant
0:34.4	polyps. But before we begin, I think it's first important to remind all the listeners that the
0:39.4	U.S. Multisociety Task Force on coloretical Cancer, with representatives from multiple GI
0:45.0	societies last issued colonoscopy surveillance recommendations in early 2020.
0:50.9	The American Society for Gastroantecsinal Endoscopy provides guidelines on how to remove
0:55.5	polyps as well as recommendations for follow-up after colonoscopy and polypectomy and these have
1:00.9	been included in our show notes for your future use.
1:04.3	But it really is important to remember that these are only guidelines and the frequency of
1:08.7	colonoscopy is influenced by many factors, some as simple as the quality of bowel preparation
1:15.2	at the time of your scope.
1:16.9	And this should be mentioned in every report,
1:19.1	so you have to remain up to date.
1:21.3	And remember, there are things like the Boston Bowel Prep score that you really
1:25.4	should know.
1:27.7	Before we start talking about advanced malignant polyps, I think it's worth repeating to everybody so that we know in the past 10 to 15 years
1:35.5	they have lowered the screening age from 50 to 45. The answer on your absight score is 45
1:41.5	for average risk patients for their first
1:44.0	colonoscopy and Kola Guard is a stool-based test and it detects three things.
1:49.6	It picks up on Enoglobin and then it also picks up on two other separate DNA mutations that are related to colorectal
	...

Please login to see the full transcript.

Previous episode | Next episode

Disclaimer: The podcast and artwork embedded on this page are from Behind The Knife: The Surgery Podcast, and are the property of its owner and not affiliated with or endorsed by Tapesearch.

Generated transcripts are the property of Behind The Knife: The Surgery Podcast and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.