Office based polypectomy of large colonic polyps is safe and effective

Morton, Jasmine

doi:10.1016/s0002-9270(02)05400-x

Cited by 8 publications

(7 citation statements)

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“…In the univariate analysis, our polyp-based univariate analysis revealed a significantly higher risk for IPPB when there were larger and multiple polyps. Polyps associated with IPPB were significantly larger than polyps not so associated; this finding confirms prior reports (27)(28)(29)(30)(31). Also, in the multivariate analysis, there was a significant association noted in polyp size >1 cm and the risk for IPPB with an OR 2.38.…”

Section: Discussionsupporting

confidence: 89%

Risk Factors for Immediate Postpolypectomy Bleeding of the Colon: A Multicenter Study

et al. 2006

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OBJECTIVES: The aims of this prospective study were to document the incidence of colon immediate postpolypectomy bleeding (IPPB) according to grade, and to identify potential risk factors of IPPB in patients who have received complete colonoscopy and polypectomy because of a colorectal polyp. METHODS:This was a prospective, cross-sectional study of 5,152 patients treated at 11 tertiary medical centers between July 2003 and July 2004. Patient-related, polyp-related, and procedure-related variables were evaluated as potential risk factors for IPPB. IPPB was defined as a bleeding occurring during the procedure and was graded as G1-G4. Risk factors associated with IPPB were analyzed by univariate and multivariate logistic regression analysis. RESULTS:A total of 9,336 colonic polyps were removed in 5,152 patients, and 262 (2.8%) colorectal polyps in 215 patients presented with IPPB. Polyp-based multivariate analysis revealed that old age (≥65 yr), comorbid cardiovascular or chronic renal disease, anticoagulant use, polyp size greater than 1 cm, gross morphology of polyps such as pedunculated polyp or laterally spreading tumor, poorer bowel preparation, cutting mode of the electrosurgical current, and the inadvertent cutting of a polyp before current application were significant risk factors for IPPB.CONCLUSION: Nine factors have been found to be associated with IPPB and polypectomy should be undertaken with caution under these conditions.

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Section: Discussionsupporting

confidence: 89%

Risk Factors for Immediate Postpolypectomy Bleeding of the Colon: A Multicenter Study

et al. 2006

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“…defined ‘high‐risk’ tubular adenomas as>10.0 mm 8 but the smallest size defined as ‘large’ for the purposes of endoscopic resection was 15.0 mm 3 . The most common minimum size for an adenoma to be considered ‘large’ is 20 mm 4−6 and while 30 mm polyps are certainly large 2 they are sometimes called ‘giant’ 1,9 . A more practical definition of ‘large’ can be derived from a recent study of a cohort of patients who were all referred for surgical resection of a colonic polyp.…”

Section: Discussionmentioning

confidence: 99%

“…Neither surgery nor endoscopy is a perfect way of treating large colonic polyps but because endoscopic resection is cheaper and less risky it is usually tried first. The outcomes of recent series of endoscopic polypectomy (Table 1) are variable with polyp persistence rates of 0−55% and complication rates from 1 to 9% 1−6 . However, most of these series are small and use different inclusion criteria.…”

Section: Introductionmentioning

confidence: 99%

Experience in the endoscopic management of large colonic polyps

Church

2003

ANZ Journal of Surgery

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“…Therefore, the decision as to whether or not to remove a large benignappearing polyp is based on a visual estimate as to whether a polyp is benign [10]. Once the decision is taken, even large polyps can be resected safely without patient's hospitalisation if the skill of the operator is appropriate for the type of resection [11,12].…”

Section: Polypectomy Methodsmentioning

confidence: 99%

Endoscopic polypectomy: techniques, complications and follow-up

Repici

Tricerri

2004

Tech Coloproctol

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Colorectal cancer is one of the most common cancers in developed countries. Increasing numbers of early stage colorectal cancers and precancerous adenomatous lesions, polypoidal type lesions, and flat and depressed type lesions can be visualised and treated endoscopically thanks to endoscopic ultrasonography, high magnification chromoendoscopy and other technical advances. Polypectomy is generally considered for protuberant lesions, with both sessile and pedunculate morphology, and endoscopic mucosal resection (EMR) is indicated for superficial, flat or depressed types of lesions. Endoscopic therapy for colonic adenoma with dysplasia and early colorectal cancer is more advantageous than the conventional operative treatment, in that it is a relatively non-invasive and less costly method. However, endoscopic therapy is completely ineffective in lesions with lymph node or distant metastasis. Therefore, it is becoming more and more important to understand the correct indications and limitations of endoscopic polypectomy/mucosectomy as well as complication rates and the correct follow-up schedule.

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Office based polypectomy of large colonic polyps is safe and effective

Cited by 8 publications

References 0 publications

Risk Factors for Immediate Postpolypectomy Bleeding of the Colon: A Multicenter Study

Risk Factors for Immediate Postpolypectomy Bleeding of the Colon: A Multicenter Study

Experience in the endoscopic management of large colonic polyps

Endoscopic polypectomy: techniques, complications and follow-up

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