Background: The most common complication of polypectomy is hemorrhage, and various techniques have been used to prevent this complication. Aim: This study evaluates the outcomes of endoclip-assisted polypectomy in patients with large pedunculated colorectal polyps, in comparison with a historical control group of patients treated with endoloop-assisted polypectomy. Methods: Between January and December 2007, 32 patients with 32 large pedunculated polyps (≥15 mm) were treated with endoclip-assisted polypectomy (group A). Between January and December 2006, 35 patients with 35 large pedunculated polyps were treated; 33 with endoloop-assisted polypectomy (control, group B) and two cases with endoclips and needle knife, which were included in group A for the analysis. Results: The mean (± standard deviation [SD]) size of polyp head was 26.8 ± 8.1 mm (range 15-50) in group A and 22.3 ± 4.1 mm (range 15-30) in group B (P = 0.004). In group A, six polyps had a mean (±SD) head size of 40.8 ± 5.8 mm (range 35-50) and were resected with clips and needle knife. In group A, bleeding occurred in two cases (5.9%), which were associated with the presence of cancer at histology (P = 0.006) and were managed by applying new clips. No bleeding occurred in patients of group B and no perforation and post-polypectomy syndrome occurred in either group. There were three (8.8%) cancerized adenomas in group A and one (3%) in group B. Clip application was possible in all patients, while in two cases, loop placement was impossible. Conclusions: In our experience, endoclip-assisted resection is a safe alternative to endoloop for the resection of large pedunculated colorectal polyps when endoloop placement is difficult or impossible. © 2009 Springer Science+Business Media, LLC.
Luigiano, C., Ferrara, F., Ghersi, S., Fabbri, C., Cennamo, V., Landi, P., et al. (2010). Endoclip-assisted resection of large pedunculated colorectal polyps: Technical aspects and outcome. DIGESTIVE DISEASES AND SCIENCES, 55(6), 1726-1731 [10.1007/s10620-009-0905-2].
Endoclip-assisted resection of large pedunculated colorectal polyps: Technical aspects and outcome
Fabbri C.;Billi P.;
2010
Abstract
Background: The most common complication of polypectomy is hemorrhage, and various techniques have been used to prevent this complication. Aim: This study evaluates the outcomes of endoclip-assisted polypectomy in patients with large pedunculated colorectal polyps, in comparison with a historical control group of patients treated with endoloop-assisted polypectomy. Methods: Between January and December 2007, 32 patients with 32 large pedunculated polyps (≥15 mm) were treated with endoclip-assisted polypectomy (group A). Between January and December 2006, 35 patients with 35 large pedunculated polyps were treated; 33 with endoloop-assisted polypectomy (control, group B) and two cases with endoclips and needle knife, which were included in group A for the analysis. Results: The mean (± standard deviation [SD]) size of polyp head was 26.8 ± 8.1 mm (range 15-50) in group A and 22.3 ± 4.1 mm (range 15-30) in group B (P = 0.004). In group A, six polyps had a mean (±SD) head size of 40.8 ± 5.8 mm (range 35-50) and were resected with clips and needle knife. In group A, bleeding occurred in two cases (5.9%), which were associated with the presence of cancer at histology (P = 0.006) and were managed by applying new clips. No bleeding occurred in patients of group B and no perforation and post-polypectomy syndrome occurred in either group. There were three (8.8%) cancerized adenomas in group A and one (3%) in group B. Clip application was possible in all patients, while in two cases, loop placement was impossible. Conclusions: In our experience, endoclip-assisted resection is a safe alternative to endoloop for the resection of large pedunculated colorectal polyps when endoloop placement is difficult or impossible. © 2009 Springer Science+Business Media, LLC.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
