AI Article Synopsis
- Experienced endoscopists face challenges in completely removing large sessile colorectal polyps, leading to the development of a new removal technique.
- The technique involves submucosal saline injection and a circumferential incision before resection with a special snare, successfully treating 33 polyps averaging 4.0 cm in size.
- Results showed 76% of polyps were resected piecemeal with minimal complications, and no residual tumors were found, indicating that this method is both safe and effective, especially for flat nodular polyps.
Article Abstract
Background: It can be difficult, even for experienced endoscopists, to completely remove large sessile colorectal polyps. We attempted to remove large sessile colorectal polyps without complication and residual tumors.
Method: Our new technique is characterized by submucosal pre-injection with a large volume of saline solution and then circumferential incision outside the lesion before resection using a special needle-tipped snare. The mean size of 33 polyps (including 9 elevated sessile, 20 flat nodular [villous], and 4 flat sessile polyps), was 4.0 cm (range, 3.0-8.5 cm).
Results: Twenty-five (76%) were resected piecemeal and the remainder as a single specimen. Mild to moderate bleeding occurred in 3 (9.1%), but there was no clinically significant bleeding or perforation. No residual or recurrent tumors were recognized. Invasive carcinoma was revealed most frequently (44%) in elevated sessile polyps; none occurred in flat nodular polyps.
Conclusion: Our removal technique appears to be safe and effective. Flat nodular polyps of any size are a particularly good indication for removal by this technique.
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| http://dx.doi.org/10.1016/s0016-5107(96)70314-0 | DOI Listing |
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