Endoclip-assisted resection of large pedunculated colorectal polyps: technical aspects and outcome.

Autor:	Luigiano, Carmelo, Ferrara, Francesco, Ghersi, Stefania, Fabbri, Carlo, Cennamo, Vincenzo, Landi, Patrizia, Polifemo, Anna Maria, Billi, Paola, Bassi, Marco, Consolo, Pierluigi, Alibrandi, Angela, D'Imperio, Nicola
Předmět:	HEMORRHAGE POLYPS CANCER patients ADENOMA SURGICAL excision HEMORRHAGE prevention PREVENTION of surgical complications SURGICAL hemostasis COLONOSCOPY GASTROINTESTINAL hemorrhage LONGITUDINAL method RECTAL diseases SURGICAL complications PRODUCT design TREATMENT effectiveness CASE-control method COLON polyps SURGERY EQUIPMENT & supplies PREVENTION
Zdroj:	Digestive Diseases & Sciences; Jun2010, Vol. 55 Issue 6, p1726-1731, 6p, 1 Chart
Abstrakt:	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. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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