ABSTRACT
Adequate bowel preparation is necessary before polypectomy, partly to ensure visualization but also in order to remove potentially explosive hydrogen and methane gas. Antibiotic prophylaxis is indicated for patients at high risk of endocarditis and for those with severe immuno-suppression where symptomatic bacteraemia is more likely. Small polyps under 5 mm in diameter comprise over 90% of polyps encountered in the colon, and usually prove histologically to be adenomatous. Without magnification or high-resolution, the endoscopist usually cannot predict on visual grounds which small polyp will be an adenoma, as opposed to a non-neoplastic hyperplastic polyp which might be ignored. Large stalked polyps require conventional 5–6 cm oval or hexagonal snares for resection. Several new developments have improved detection of colonic neoplasia and facilitated the endoscopic resection of larger, sessile polyps and even early cancers. Small polyps under 5 mm in diameter comprise over 90% of polyps encountered in the colon, and usually prove histologically to be adenomatous.
