Abstract

Background/Aims
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)

• Keywords: Colonic Polyps; Detachable Snare; Polypectomy; Hemorrhage; Complete Resection Rate