Colorectal Polyps and Polyposis Syndromes

Paul E. Wise, MD, FACS, FASCRS

Whether focused only on endoscopy or encompassing the broad array of surgical, minimally invasive, and endoscopic techniques that constitute the modern colon and rectal surgery practice, a solid familiarity, if not deeper understanding, of polyps and neoplasia is required. This issue of Clinics in Colon and Rectal Surgery serves as a prequel, of sorts, to the 2015 issues on colon cancer and rectal cancer—a means to gain a deeper understanding of the pathogenesis, diagnosis, management, surveillance for, and prevention of colorectal polyps and their associated polyposis syndromes. After completing this issue, readers should have a better understanding of the genetics and pathogenesis of colorectal polyps (not just adenomas), including their potential pathways to carcinogenesis described in the section by Drs. Klos and Dharmarajan. Additionally, from the work of Drs. Huck and Bohl, the reader should understand diagnostic methods and current surveillance recommendations, including noninvasive and radiographic techniques, for colorectal polyps. Options for endoscopic and surgical treatments of benign and malignant colonic polyps, with special considerations for rectal polyps, will be elucidated by Drs. Huang and Sarin as well as Drs. Cowan and Silviera. The readers will then be able to describe the adenomatous polyposis syndromes as well as their treatment, surveillance, and extracolonic considerations after reading the work of Drs. Mitchem and Hall. Hamartomatous polyps and their associated syndromes will be clarified by Dr. Cone while serrated polyps and their associated syndromes will be addressed by Drs. Ashburn, Plesec, and Kalady, furthering the readers' understanding of the diagnostic criteria, treatment, and surveillance of these conditions. The reader's ability to explain the import of genetic counseling and testing for polyposis syndromes, focusing on current technology and the impact of genetic testing on care, will be heightened after reading the section by Khateriaa Pyrtel (MS, CGC). Finally, and perhaps most importantly, the reader will be able to explain polyp prevention strategies, including chemoprevention options, after reviewing the section by Drs. Dolejs, Gayed, and Fajardo. The hope is that this review and update on “Polyps and Polyposis Syndromes” will allow the reader to improve the care of their patients while furthering their ability to educate others on this ever-expanding and critical facet of any colon and rectal surgery practice.