For “difficult” benign colorectal lesions referred to surgical resection a second opinion by an experienced endoscopist is mandatory: A single centre experience

Table 1 Characteristics of patients and colorectal lesions recruited

No. of patients	82
Age (mm ± SD) (range)	62 ± 10 (38-81)
Sex (M/F)	40/42
Associated extra-intestinal diseases (%)
Hypertension	6 (7.5)
Cardiac diseases	3 (3.5)
Chronic renal failure	1 (1.5)
Neoplasms	1 (1.5)
Diabetes mellitus	1 (1.5)
Associated intestinal diseases (%)
Diverticula	15 (18)
Others colorectal lesions	10 (12)
Left hemicolectomy	3 (3.5)
Number of lesions	82
Size (mm ± SD) (range)	37 ± 18 (20-100)
Indication for surgical resection (%)
Location	36 (44)
Size	32 (39)
Shape	10 (12)
Recurrence	4 (5)
Shape (%)
0-Ip	11 (13)
0-Isp	1 (1.5)
0-Is	17 (21)
0–IIa	19 (23)
0–IIa + Is	18 (22)
0–IIa + IIc	12 (14.5)
0–IIb	4 (5)
Location (%)
Anorectal junction	4 (5)
Rectal	7 (8.5)
Rectosigmoid junction	14 (17)
Sigmoid	16 (19)
Descending colon	3 (4)
Splenic flexure	4 (5)
Transverse	3 (3.5)
Hepatic flexure	10 (12)
Ascending colon	8 (10)
Caecum only	9 (11)
Cecum with ileocecal valve involvement	3 (3.5)
Cecum with appendix orifice involved	1 (1.5)
Biopsy results at the first colonoscopy (%)
Low-grade dysplasia	18 (22)
High-grade dysplasia	64 (78)
Successful endoscopic resection (%)	69 (84)
Aborted endoscopic resection (%)	13 (16)
Non-lifting sign	6
Frankly malignant lesions	3
Difficult position	2
Very large lesions with difficult position	2

mm: Millimeters; M: Male; F: Female; 0-Ip: Pedunculated lesions; 0-Isp: Semi-pedunculated lesions; 0-Is: Sessile lesions; 0-IIa: Elevated non-polypoid lesions; 0-IIb: Barely perceptible elevated non-polypoid lesions; 0–IIc: Slightly depressed non-polypoid lesions.

Table 2 Characteristics of colorectal lesions resected

No. of lesions	69
Size (mm ± SD) (range)	33 ± 12 (20-80)
Shape (%)
0-Ip	11 (16)
0-Isp	1 (1.5)
0-Is	15 (22)
0–IIa	16 (23)
0–IIa + Is	15 (22)
0–IIa + IIc	8 (11.5)
0–IIb	3 (4)
Location (%)
Anorectal junction	4 (6)
Rectal	6 (8.5)
Rectosigmoid junction	13 (19)
Sigmoid	15 (22)
Descending colon	2 (3)
Splenic flexure	3 (4)
Transverse	1 (1.5)
Hepatic flexure	9 (13)
Ascending colon	6 (8.5)
Caecum only	8 (11.5)
Cecum with ileocecal valve involvement	2 (3)
Technique of endoscopic resection for the 57 sessile and non-polypoid lesions
En-bloc endoscopic mucosal resection	23
Piecemeal endoscopic mucosal resection	34
Resection with argon plasma coaugulation	15
Technique of endoscopic resection for the 12 pedunculated and semipedunculated lesions
Clips	9
Endoloop	3
Complications (%)	11 (16)
Bleeding	7
Perforation	2
Transmural burn syndrome	2
Histology (%)
Tubular adenoma	13 (19)
Villous adenoma	22 (32)
Tubulovillous adenoma	33 (47.5)
Serrated adenoma	1 (1.5)
Low-grade dysplasia	3 (4)
High-grade dysplasia	45 (65.5)
Intramucosal cancer	14 (20.5)
Invasive cancer	7 (10)

mm: Millimeters; 0-Ip: Pedunculated lesions; 0-Isp: Semi-pedunculated lesions; 0-Is: Sessile lesions; 0-IIa: Elevated non-polypoid lesions; 0-IIb: Barely perceptible elevated non-polypoid lesions; 0–IIc: Slightly depressed non-polypoid lesions.