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Endoscopic resection of large colorectal polyps.
F Pérez Roldán1, P González Carro, M L Legaz Huidobro
1Service of Digestive Diseases, Department of Internal Medicine, Complejo Hospitalario La Mancha-Centro, Alcázar de San Juan, Ciudad Real, Spain. perezrold@teleline.es
Revista Espanola De Enfermedades Digestivas
|February 20, 2004
Summary
Endoscopic polypectomy is a safe and effective treatment for large colorectal polyps, achieving high complete resection rates. While complications can occur, it is a preferred method except for invasive carcinomas.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Colorectal Cancer Prevention
Background:
- Discrepancies exist regarding the optimal treatment for colorectal polyps measuring 2 cm or larger, with both surgical and endoscopic approaches considered.
- Colonoscopic polypectomy is a widely used technique for polyp removal.
Purpose of the Study:
- To evaluate the efficacy and safety of colonoscopic polypectomy for large colorectal polyps.
- To analyze the complication rates associated with the procedure.
Main Methods:
- A retrospective analysis of 147 colonoscopic polypectomies performed on 142 patients over eight years.
- Techniques included submucosal injection, diathermic snare resection, argon plasma coagulation, and prophylactic hemoclips for specific polyp types.
- Complete removal was defined as successful resection in one or more sessions; failure was defined by incomplete resection or invasive carcinoma.
Main Results:
- The study included 142 patients (mean age 67.9 years; 68 men, 79 women).
- Most polyps (96.6%) were successfully resected and cured, with pedunculated polyps removed in one session and sessile polyps requiring an average of 1.35 sessions.
- Complications included 2 colonic perforations and 8 hemorrhages, all managed endoscopically, with no associated mortality.
Conclusions:
- Colonoscopic polypectomy is a safe and effective treatment for large colorectal polyps (≥2 cm).
- High rates of complete resection and low relapse rates support its consideration as a primary treatment modality.
- The technique is recommended except in cases involving invasive carcinoma.