Endoscopic Resection of Large Non-Pedunculated Colonic Polyps Without Submucosal Injection Is Safe and Effective with...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Cancer Prevention

Background:

• Submucosal injection (SI) with lift polypectomy is standard for large non-pedunculated colorectal polyps.
• Limited comparative data exists on safety and efficacy of large polypectomies with and without SI.

Purpose of the Study:

• To evaluate the feasibility and safety of colorectal polyp resection without SI.
• To compare outcomes of polypectomy with and without SI for large non-pedunculated polyps.

Main Methods:

• Retrospective study of 200 large non-pedunculated colorectal polyp resections (≥20 mm) from 2018-2021.
• Data collected on demographics, polyp characteristics, resection technique, complications, and recurrence.
• Comparison between polyps resected with and without SI.

Main Results:

• No significant difference in delayed bleeding rates between groups.
• Perforation occurred in 5 cases with SI, none without SI (not statistically significant).
• Similar polyp recurrence rates at 6-12 months (12% no-SI vs. 8% SI).

Conclusions:

• Complete removal of large non-pedunculated polyps without SI is feasible and safe.
• The no-SI approach demonstrated comparable outcomes to routine SI use regarding bleeding and perforation.
• Randomized trials are recommended to further validate the safety and efficacy of polypectomy without SI.