H Iishi1, M Tatsuta, H Narahara, K Iseki, N Sakai. 1. Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.
Abstract
BACKGROUND:Colonoscopic resection of pedunculated polyps with heads 1 cm or greater in diameter is difficult because of the risk of bleeding. To minimize this complication, we used a detachable snare that allowed endoscopic ligation of the stalk of a large pedunculated polyp and evaluated its safety and effectiveness in comparison with conventional endoscopic snare polypectomy. METHODS:Patients with pedunculated polyps with heads 1 cm or greater in diameter were randomly assigned to colonoscopic polypectomy with (N = 47) or without (N = 42) a detachable snare. Arterial pumping bleeding immediately after colonoscopic polypectomy or hematochezia resulting in a 10% or greater drop in hematocrit was defined as "bleeding." RESULTS: No bleeding occurred during or after polypectomy with a detachable snare, but bleeding occurred significantly more frequently (five patients, 12%) without a snare. Moreover, the use of a detachable snare reduced the duration of hospitalization after polypectomy. CONCLUSIONS:Colonoscopic polypectomy with a detachable snare may be safer than conventional polypectomy without a detachable snare for resection of large, pedunculated polyps.
RCT Entities:
BACKGROUND: Colonoscopic resection of pedunculated polyps with heads 1 cm or greater in diameter is difficult because of the risk of bleeding. To minimize this complication, we used a detachable snare that allowed endoscopic ligation of the stalk of a large pedunculated polyp and evaluated its safety and effectiveness in comparison with conventional endoscopic snare polypectomy. METHODS:Patients with pedunculated polyps with heads 1 cm or greater in diameter were randomly assigned to colonoscopic polypectomy with (N = 47) or without (N = 42) a detachable snare. Arterial pumping bleeding immediately after colonoscopic polypectomy or hematochezia resulting in a 10% or greater drop in hematocrit was defined as "bleeding." RESULTS: No bleeding occurred during or after polypectomy with a detachable snare, but bleeding occurred significantly more frequently (five patients, 12%) without a snare. Moreover, the use of a detachable snare reduced the duration of hospitalization after polypectomy. CONCLUSIONS: Colonoscopic polypectomy with a detachable snare may be safer than conventional polypectomy without a detachable snare for resection of large, pedunculated polyps.
Authors: Douglas K Rex; Philip S Schoenfeld; Jonathan Cohen; Irving M Pike; Douglas G Adler; M Brian Fennerty; John G Lieb; Walter G Park; Maged K Rizk; Mandeep S Sawhney; Nicholas J Shaheen; Sachin Wani; David S Weinberg Journal: Am J Gastroenterol Date: 2014-12-02 Impact factor: 10.864
Authors: R Manta; F Tremolaterra; A Arezzo; M Verra; G Galloro; L Dioscoridi; F Pugliese; A Zullo; M Mutignani; G Bassotti Journal: Tech Coloproctol Date: 2015-07-11 Impact factor: 3.781