Related Experiment Video
Updated: Dec 15, 2025
Author Spotlight: A Reproductive Hysteroscopy Approach for Complete Endometrial Polyp Removal and Enhanced Endometrial Receptivity
Published on: August 2, 2024
Endoscopic submucosal dissection of large pedunculated polyps with wide stalks: a retrospective multicenter study
Hideyuki Chiba1, Jun Tachikawa1, Jun Arimoto1
1Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan.
Background:
Endoscopic resection of large pedunculated colorectal polyps is technically difficult, especially when the polyp is large and has such a thick stalk that it is either too difficult or impossible to resect prophylactically by a conventional snare. Here, we evaluated the feasibility of ESD for large pedunculated polyps with wide stalks.
Methods:
29 patients with large pedunculated polyps that were not resectable by polypectomy or endoscopic mucosal resection were enrolled in the study.
Results:
En bloc resection was achieved in 28/29 polyps. One suspended case was due to severe fibrosis with muscle retraction signs. The mean diameter of the 29 polyp heads was 39.7 (standard deviation 6.9) mm. Submucosal fibrosis was present in 16 polyps (9 mild; 7 severe). The stalks of severely fibrotic polyps were significantly thicker than those of polyps with no or mild fibrosis. The curative resection rate was 85.7 % without severe complications.
Conclusions:
ESD is feasible for the removal of large pedunculated polyps with wide stalks when conventional snare resection is difficult or impossible.
