Role of advanced endoscopic resection techniques in the management of colorectal lesions

Over-treatment of colorectal lesions with standard oncological resection even when the lesion is benign has led the way to advanced endoscopic resection methods. Endoscopic submucosal dissection (ESD) allows en bloc removal of the lesion and this permits accurate histopathological evaluation (1). Combined endoscopic-laparoscopic surgery (CELS) is performed in more advanced cases where the resection is not feasible without manipulating the colon and/or when additional interventions are required to close the defect after endoscopic resection. Eventually CELS can facilitate wedge resections when pure endoscopic excision is not feasible.