Document Detail


Endoclip-assisted resection of large pedunculated colorectal polyps: technical aspects and outcome.
MedLine Citation:
PMID:  19657735     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The most common complication of polypectomy is hemorrhage, and various techniques have been used to prevent this complication. AIM: This study evaluates the outcomes of endoclip-assisted polypectomy in patients with large pedunculated colorectal polyps, in comparison with a historical control group of patients treated with endoloop-assisted polypectomy. METHODS: Between January and December 2007, 32 patients with 32 large pedunculated polyps (>or=15 mm) were treated with endoclip-assisted polypectomy (group A). Between January and December 2006, 35 patients with 35 large pedunculated polyps were treated; 33 with endoloop-assisted polypectomy (control, group B) and two cases with endoclips and needle knife, which were included in group A for the analysis. RESULTS: The mean (+/- standard deviation [SD]) size of polyp head was 26.8 +/- 8.1 mm (range 15-50) in group A and 22.3 +/- 4.1 mm (range 15-30) in group B (P = 0.004). In group A, six polyps had a mean (+/-SD) head size of 40.8 +/- 5.8 mm (range 35-50) and were resected with clips and needle knife. In group A, bleeding occurred in two cases (5.9%), which were associated with the presence of cancer at histology (P = 0.006) and were managed by applying new clips. No bleeding occurred in patients of group B and no perforation and post-polypectomy syndrome occurred in either group. There were three (8.8%) cancerized adenomas in group A and one (3%) in group B. Clip application was possible in all patients, while in two cases, loop placement was impossible. CONCLUSIONS: In our experience, endoclip-assisted resection is a safe alternative to endoloop for the resection of large pedunculated colorectal polyps when endoloop placement is difficult or impossible.
Authors:
Carmelo Luigiano; Francesco Ferrara; Stefania Ghersi; Carlo Fabbri; Vincenzo Cennamo; Patrizia Landi; Anna Maria Polifemo; Paola Billi; Marco Bassi; Pierluigi Consolo; Angela Alibrandi; Nicola D'Imperio
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Publication Detail:
Type:  Journal Article     Date:  2009-08-06
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  55     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-09     Completed Date:  2010-07-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1726-31     Citation Subset:  AIM; IM    
Affiliation:
Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Largo Nigrisoli 2, Bologna, Italy. carmeluigiano@libero.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Case-Control Studies
Colonic Polyps / pathology,  surgery*
Colonoscopes*
Colonoscopy* / adverse effects
Equipment Design
Female
Gastrointestinal Hemorrhage / etiology,  prevention & control
Hemostasis, Surgical / instrumentation*
Humans
Male
Middle Aged
Polyps / pathology,  surgery*
Postoperative Hemorrhage / etiology,  prevention & control
Prospective Studies
Rectal Diseases / pathology,  surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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