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Insulated-tip knife endoscopic polypectomy for difficult pedunculated colorectal polyps: a prospective pilot study
Lianjun Ma1,2, Yaqi Zhai1, Ningli Chai1
1Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, China.
Background:
Endoscopic polypectomy is widely used for colorectal polyps. However, for giant pedunculated colorectal polyps (≥3 cm), conventional techniques are so difficult with en bloc resection that patients had to be transferred to surgery. We had firstly reported our first experience with an insulated-tip knife to successfully remove a giant pedunculated polyp in the sigmoid colon. In this study, our aim was to explore safety and feasible of insulated-tip knife endoscopic polypectomy (IT-EP) for difficult pedunculated colorectal polyps.
Methods:
A total of seven consecutive patients with giant pedunculated colorectal polyps (≥3 cm) were prospectively enrolled. IT-EP was conducted with the help of clips for all the seven patients, and data of them was recorded and analyzed.
Results:
Of seven patients, five were men and two were women with a mean age 61 years (49-72 years). The mean diameter of polyp head and stalk was 36.4 ± 4.9 mm (30-42 mm) and 14.6 ± 3.6 mm (10-20 mm), respectively. All the polyps were successfully removed with IT-EP, with a mean operation time of 14.9 ± 3.5 min (11-20 min). No serious bleeding or perforation was experienced, and no surgery was needed. There was no recurrence or residual of polyps at a mean 8.1-month follow-up.
Conclusions:
Insulated-tip knife endoscopic polypectomy is a safe and feasible alternative for difficult pedunculated colorectal polyps.
