Endoscopic resection of adenomatous lesions of the colon

Introduction: Most colon tumors develop from malignant degeneration of precursor lesions (adenoma-carcinoma sequence). Adenomas are benign lesions that do not recur once they are completely resected. The least invasive treatment for these lesions is endoscopic resection. Objective: To deepen the knowledge related to endoscopic resection techniques of adenomatous lesions of the colon. Development: The detection of adenomas constitutes a challenge in the early detection strategy for colorectal cancer. Polypectomy is the most important tool for its prevention. The polypectomy technique for tiny, small polyps is variable, and the choice is based on the size of the polyp and the physician's preference. Techniques used include hot loop polypectomy, cold loop polypectomy, cold biopsy forceps, and hot biopsy forceps. These techniques have risks of complications, including bleeding and perforation. The use of electrocautery increases the risk of transmural colon injury, late post-polypectomy hemorrhage, and perforation. Cold loop polypectomy is a technique with well-established safety. Conclusions: Cold snare polypectomy is superior to cold biopsy forceps for complete resection of minute polyps. Cold loop polypectomy is more effective than forceps techniques in achieving complete resection of the polyp. It also avoids the adverse events associated with thermal electrocautery in hot biopsy forceps and hot loop techniques.