Endoscopic resection of large pedunculated colorectal polyps using a detachable snare.
BACKGROUND
Colonoscopic resection of pedunculated polyps with heads 1 cm or greater in diameter is difficult because of the risk of bleeding. To minimize this complication, we used a detachable snare that allowed endoscopic ligation of the stalk of a large pedunculated polyp and evaluated its safety and effectiveness in comparison with conventional endoscopic snare polypectomy.


METHODS
Patients with pedunculated polyps with heads 1 cm or greater in diameter were randomly assigned to colonoscopic polypectomy with (N = 47) or without (N = 42) a detachable snare. Arterial pumping bleeding immediately after colonoscopic polypectomy or hematochezia resulting in a 10% or greater drop in hematocrit was defined as "bleeding."


RESULTS
No bleeding occurred during or after polypectomy with a detachable snare, but bleeding occurred significantly more frequently (five patients, 12%) without a snare. Moreover, the use of a detachable snare reduced the duration of hospitalization after polypectomy.


CONCLUSIONS
Colonoscopic polypectomy with a detachable snare may be safer than conventional polypectomy without a detachable snare for resection of large, pedunculated polyps.
Iishi
H
H
Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.
Tatsuta
M
M
Narahara
H
H
Iseki
K
K
Sakai
N
N
D016063:Blood Loss, Surgical / Q000517:prevention & control; D015179:Colorectal Neoplasms / Q000601:surgery*; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D007417:Intestinal Polyps / Q000601:surgery*; D008297:Male; D008875:Middle Aged