Advances in interventional gastrointestinal endoscopy in colon and rectum.

BACKGROUND

Instrumental and procedural advances particularly in the therapeutic field have been achieved.

REVIEW: Endoscopes with larger working channel, additional jet-channel, or variable stiffness allow more sophisticated interventional procedures. Higher resolution in endoscopic image quality helps to identify early lesions that can be treated endoscopically at this stage. Polypectomy and mucosectomy are no longer limited by the size of the lesion. Piecemeal technique is established, and a retrieval net is available for collecting all pieces obviating repeated introductions of the endoscope. In addition to snare polypectomy and mucosectomy, laparoscopy-assisted polypectomy and full-thickness resection are discussed. Self-expandable metal stents are used to decompress malignant colonic obstruction allowing for either preoperative bowel preparation and elective surgery or for noninvasive palliation. Argon plasma coagulation is an inexpensive and effective method for the treatment of bleeding from radiation proctitis.