Endoscopy, allowing real-time examination of the large bowel, has evolved into a major diagnostic and therapeutic modality in coloproctology. Diagnostic colonoscopy with or without biopsy is generally a very safe procedure (<1 % risk of complication). Polypectomy, stricture dilation, coagulation of angiodysplasia, and stent placement through malignant strictures are major therapeutic interventions that can be undertaken during colonoscopy. Therapeutic procedures may lead to occasional complications, but when performed by appropriately trained clinicians, the expected benefits outweigh complication risks in patients with a clear indication.
Colonoscopy has a major role in patients follow-up after endoscopic polypectomy or colorectal cancer resection because of the risk of developing further advanced neoplastic lesions in these patients, as outlined in recent European guidelines.
Chromoendoscopy, involving applications of tissue stains or dyes to the gastrointestinal mucosa, has been used for several years to improve the detection and characterization of neoplastic lesions. New endoscopic imaging technology has recently been developed, aiming to improve mucosal visualization, including improvements in image resolution, software processing, and optical filter technology.