← Issue №4/ week of Jul 26, 2026/Endoscopy

A Practical Endoscopic Treatment Strategy for Appendiceal Orifice Lesions Using Forceps-Assisted Polypectomy (Strip Biopsy).

From GI Signals issue №4: what this paper found, what it changes, and where it sits against the current standard of care, reviewed by Simon Mathews, MD.

Endoscopy retrospective · n=22 · Jul 25, 2026 · Dig Dis Sci · IF 2.5

A Practical Endoscopic Treatment Strategy for Appendiceal Orifice Lesions Using Forceps-Assisted Polypectomy (Strip Biopsy).

New evidencepolypectomyESD
Clinical takeawayConsider strip biopsy for small appendiceal orifice lesions without malignant features, as it offers faster resection with comparable safety to ESD in this study, but be aware of higher margin positivity (50% vs. 13%).
What it foundForceps-assisted polypectomy (strip biopsy) for carefully selected small appendiceal orifice lesions without malignant features achieved 93% en bloc resection vs. 100% with ESD, with significantly shorter procedure time (6.6 vs. 45.9 min) and no perforations, but had higher margin positivity (50% vs. 13%).
ContextChallenges current overtreatment with ESD for small lesions, offering a simpler alternative with similar short-term outcomes but higher margin positivity.
Refinessuggested applicable standard· US Multi-Society Task Force on Colorectal Cancer (Gupta S, et al.), "Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2020

Decision at stakethe choice of endoscopic resection technique for appendiceal orifice lesions

No single passage of this standard matched the paper closely enough to quote, so none is shown. The standard is cited above.

Our full summary of this standard

After polyp removal, assign the next colonoscopy surveillance interval using USMSTF 2020 based on polyp number, size, and histology (e.g., 1-2 tubular adenomas <10 mm 7-10 years; 3-4 tubular adenomas <10 mm 3-5 years; 5-10 tubular adenomas <10 mm, any adenoma ≥10 mm, or adenoma with tubulovillous/villous histology or high-grade dysplasia 3 years; >10 adenomas 1 year with polyposis evaluation; and for serrated polyps, 1-2 sessile serrated lesions <10 mm 5-10 years, 3-4 sessile serrated lesions <10 mm or a hyperplastic polyp ≥10 mm 3-5 years, and a sessile serrated lesion ≥10 mm or with dysplasia or a traditional serrated adenoma 3 years), and apply the shortest interval indicated when findings are mixed. Confirm complete resection and adequate prep before applying an interval, and use site-check/tumor-board pathways for piecemeal resection and malignant (T1) polyps. Refer for genetic evaluation when Lynch, FAP/AFAP/MAP, or serrated polyposis syndrome criteria are met.

US Multi-Society Task Force on Colorectal Cancer (Gupta S, et al.), "Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2020 · reviewed 2026-07-23 ↗
Iida T … Chiba H · Digestive Diseases and Sciences · IF 2.5 · PubMed ↗Permalink
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