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Intestinal Research 2007;5(2):151-157.
Published online December 30, 2007.
Clinical Value of Endoscopic Resection of Large Colonic PolypsUsing a Detachable Snare
Jin Gook Huh, You Sun Kim, Sun Ok Kwon, Won Cheol Jang, Kyung Sun Ok, Tae Yeob Jeong, Soo Hyung Rye, Jung Hwan Lee, Jeong Seop Moon
Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
대장의 거대 용종절제술에서 박리성 올가미의 임상적 유용성
허진국, 김유선, 권선옥, 장원철, 옥경선, 정태엽, 류수형, 이정환, 문정섭
인제대학교 의과대학 서울백병원 내과학교실
A large colonic polyp is a challenge for endoscopists due to the risk of serious hemorrhage, perforation or incomplete resection. We examined whether endoscopic resection of large polyps using a detachable snare is a feasible and safe procedure. We also examined the sizes of a polyp that could be removed. Methods: We retrospectively reviewed 65 cases of endoscopic resection of large colonic polyps using a detachable snare. Results: The sizes of the polyps included 3.5 cm (n=3), 3.0 to 3.4 cm (n=8), 2.0 to 2.9 cm (n=16) and 1.0 to 1.9 cm (n=38). The mean polyp size was 1.8 cm. The pathologic diagnoses of the resected polyps included 20 adenocarcinomas (30.8%), 38 adenomas (58.5%), three hyperplastic polyps, two inflammatory polyps, one hamartomatous polyp and one lymphangioma. The complete resection rate was 98.5% (64/65). There were no complications such as perforation, delayed bleeding or the need for additional surgery. Six complications of immediate bleeding (9.2%) developed after resection, but the bleeding was easily controlled by endoscopic treatment. Conclusions: According to our study, endoscopic resection of large polyps using a detachable snare can reduce not only complications of bleeding but also incomplete resection. Therefore, polyp size alone is rarely a contraindication to the endoscopic resection of a colonic polyp. (Intest Res 2007;5:151-157)
Key Words: Colonic Polyps, Detachable Snare, Polypectomy, Hemorrhage, Complete Resection Rate
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