Resect and Discard Strategy: Why?

Introduction The prevalence of colorectal neoplasms is approximately 30-40% in asymptomatic average-risk Koreans, which is comparable with the rate in Western countries. Although colonoscopic polypectomy can decrease the incidence of colorectal cancer, polypectomy and the ensuing pathologic examinations are major determinants of the cost. However, pathologic examinations are used only for determining post-polypectomy surveillance intervals; the majority of complications are associated with polypectomy. Recently, with advances in the optical technologies, the in vivo histologic characterization of polyps has become available. Therefore, it has been proposed that the use of these optical technologies can decrease the requirement for the histologic assessment of diminutive (≤ 5 mm) or small (6-9 mm) polyps, as well as the frequency of unnecessary polypectomies. In this article, we will review what the “resect and discard” strategy means and whether this strategy is applicable in Korea.