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Colonoscopic snare polypectomy: analysis of 1485 resections comparing two types of current
A Van Gossum1, A Cozzoli, M Adler
1Department of Gastroenterology, Hôpital Erasme, Brussels, Belgium.
Abstract:
The complications related to 1485 colonic snare polypectomies were analyzed according to the type of current which was used for resection. From January 1982 to August 1986 (period 1), blended current was used in 758 snare polypectomies, while continuous coagulation current was applied in 727 polypectomies from September 1986 to October 1989 (period 2). The incidence of complications observed in the entire series was low, consisting of 0.26% perforations and 0.9% major hemorrhages. There were no deaths in this series. Twelve of 14 hemorrhages occurred after resection of polyps larger than 1 cm. Although the incidence of complications was not statistically different in the two groups, there was a significant difference in the timing of hemorrhages. All of the major hemorrhages were immediate (eight) when the blended current was used, but delayed (six; from 2 to 8 days after polyp resection), when pure coagulation current was applied.
Insights
Blended current in colonic snare polypectomies led to immediate hemorrhages, while pure coagulation current resulted in delayed bleeding. Complication rates were similar, but timing differed significantly for major hemorrhages.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
Background:
- Colonic snare polypectomy is a common endoscopic procedure.
- Understanding complications associated with different electrocautery currents is crucial for patient safety.
Purpose of the Study:
- To analyze complications of colonic snare polypectomies based on the type of electrocautery current used.
- To compare the incidence and timing of complications between blended and pure coagulation currents.
Main Methods:
- Retrospective analysis of 1485 colonic snare polypectomies.
- Comparison of outcomes between blended current (Period 1) and pure coagulation current (Period 2).
- Data collection on perforation, major hemorrhage, and timing of bleeding events.
Main Results:
- Overall complication rates were low (0.26% perforations, 0.9% major hemorrhages).
- No deaths were reported.
- Major hemorrhages (12/14) occurred after resection of polyps >1 cm.
- Blended current was associated with immediate hemorrhages (8/8), while pure coagulation current led to delayed hemorrhages (6/6, 2-8 days post-resection).
Conclusions:
- While overall complication incidence was similar, the timing of major hemorrhages differed significantly between blended and pure coagulation currents.
- Pure coagulation current may be preferred to reduce immediate post-polypectomy bleeding risk, especially for larger polyps.