{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:07:15Z","timestamp":1753877235509,"version":"3.41.2"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Large rectal adenomatous polyps are not uncommon. Proctectomy sparing interventions are favored when feasible. We present a case of a 62-year-old woman, who presented with diarrhea for several years. Colonoscopy revealed a very large 60 mm rectal polyp, biopsied as tubulovillous adenoma. This was successfully resected using a staged approach with endoscopic mucosal resection and trans-anal endoscopic microsurgery. Endoscopic mucosal resection removed 70% of the lesion with central scarred not amenable to resection but amenable to transanal excision. Pathology demonstrated tubulovillous adenoma with negative margins. Flexible sigmoidoscopy at 6-month follow-up revealed well healed scar without recurrence or residual disease. This demonstrates a staged resection for a large rectal polyp which is minimally invasive and organ preserving.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf068","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T12:17:06Z","timestamp":1738325826000},"source":"Crossref","is-referenced-by-count":0,"title":["A staged approach to resecting a large rectal polyp using endoscopic mucosal resection and trans-anal endoscopic microsurgery: a case report"],"prefix":"10.1093","volume":"2025","author":[{"given":"Bhavna A","family":"Guduguntla","sequence":"first","affiliation":[{"name":"Department of Medicine, Barnes-Jewish Hospital\/Washington University in St. Louis , 660 S. Euclid Ave., MSC 8066-22-6602, St. Louis, MO 63110,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared","family":"Yee","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Section of Colon and Rectal Surgery, Barnes-Jewish Hospital\/Washington University in St. Louis , 4590 Children\u2019s Place, Suite 9600, St. Louis, Missouri 63110,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul E","family":"Wise","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Section of Colon and Rectal Surgery, Barnes-Jewish Hospital\/Washington University in St. Louis , 4590 Children\u2019s Place, Suite 9600, St. Louis, Missouri 63110,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad Najdat","family":"Bazarbashi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology and Hepatology, Barnes-Jewish Hospital\/Washington University in St. Louis , 660 S. Euclid Avenue, MSC 8124-0086-09, St. Louis, MO 63110,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"2025021908154423600_ref1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.728704","article-title":"Endoscopic Management of complex colorectal polyps: current insights and future trends","volume":"8","author":"Mann","year":"2022","journal-title":"Front Med"},{"key":"2025021908154423600_ref2","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1055\/s-0035-1570395","article-title":"Transanal approach to rectal polyps and cancer","volume":"29","author":"Rai","year":"2016","journal-title":"Clin Colon Rectal Surg"},{"key":"2025021908154423600_ref3","doi-asserted-by":"publisher","first-page":"3925","DOI":"10.3748\/wjg.v27.i25.3925","article-title":"Endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal polyps: a meta-analysis and meta-regression with single arm analysis","volume":"27","author":"Lim","year":"2021","journal-title":"World J Gastroenterol"},{"key":"2025021908154423600_ref4","first-page":"133","article-title":"Endoscopic mucosal resection: best practices for gastrointestinal endoscopists","volume":"18","author":"Thiruvengadam","year":"2022","journal-title":"Gastroenterol Hepatol (N Y)"},{"key":"2025021908154423600_ref5","doi-asserted-by":"publisher","first-page":"45","DOI":"10.7812\/tpp\/11-120","article-title":"Transanal endoscopic microsurgery for rectal tumors: a review","volume":"16","author":"Kunitake","year":"2012","journal-title":"Perm J"},{"key":"2025021908154423600_ref6","doi-asserted-by":"publisher","first-page":"1977","DOI":"10.1056\/NEJM199312303292701","article-title":"Prevention of colorectal cancer by colonoscopic polypectomy. 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