Colonoscopic resection of large colonic polyps--a prospective study

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Cancer Prevention

Background:

• Large colonic polyps often necessitate surgical resection.
• Endoscopic polypectomy is a less invasive alternative.

Purpose of the Study:

• To evaluate the safety and efficacy of endoscopic polypectomy for large colonic polyps.
• To determine if endoscopic polypectomy can defer surgical treatment.

Main Methods:

• Retrospective analysis of 25 patients undergoing endoscopic polypectomy for large colonic polyps (3.0-6.0 cm).
• Follow-up for a mean of 48 months.
• Pathological examination of resected polyps.

Main Results:

• Endoscopic polypectomy was successful in all 25 patients, with 52% requiring piecemeal resection.
• Malignancy was found in 44% of polyps.
• Complications were minor (12% bleeding, 4% fever/diarrhea) and managed conservatively.
• Two patients were referred for surgery due to invasion or synchronous malignancy.
• 8 metachronous polyps were detected during follow-up, one requiring endoscopic treatment for carcinoma.

Conclusions:

• Endoscopic polypectomy is a safe and viable option for managing large colonic polyps, often avoiding surgery.
• Careful patient selection and regular endoscopic surveillance are essential after polypectomy.
• Consider endoscopic polypectomy before surgical referral for large polyps.