Complication rates of colonic polypectomy in relation to polyp characteristics and techniques: a district hospital experience.

BACKGROUND: Colonic polypectomy reduces the subsequent rate of development of colonic cancer but is not without its risks. We aimed to examine our complication rates in relation to the characteristics of polyps and techniques employed.
METHODS: A database for all colonic polypectomies performed over a 3½-year period between 2006 and 2009 was matched against all patients readmitted after an endoscopy. Serious complications post-polypectomy were defined as events leading to readmission within 14 days.
RESULTS: We performed 2106 polypectomies on 1252 patients in this period. Fourteen patients or 24 (1.1%) polypectomies experienced complications. Two patients (0.09%) experienced perforation, 10 (0.47%) had bleeding and 3 (0.14%) had post-polypectomy syndromes. Our bleeding rate was 1:211, lower than the national standard of 1:100. No deaths were reported. Complication rates rose from 1% in the smallest group (1-10 mm) to 4.9% in the largest (>31 mm) but the difference was not statistically significant (p=0.067). Right-colon polypectomies had a higher tendency of developing post-polypectomy syndrome and bleeding (p=0.002). Complication rates in snare polypectomies were not significantly different from that of hot biopsies (p=0.64). However, endoscopic mucosal resections (EMR) had significantly more complications compared to snares (p=0.045) and hot biopsies (p=0.026).
CONCLUSION: We achieved lower bleeding rates than that published nationally. Hot biopsies did not carry a higher risk unlike EMRs. Although polyp size may be an important risk factor, statistical significance was not met. Ascending and transverse colon polypectomies carried the highest risks of complications.