Endoscopic resection with hypertonic saline-solution-epinephrine injection plus band ligation for large pedunculated or semipedunculated gastric polyp.
BACKGROUND
Endoscopic resection of pedunculated polyps with heads 1 cm or greater in diameter presents a risk of bleeding. To minimize this complication, we performed endoscopic resection with hypertonic saline-solution-epinephrine injection plus band ligation and evaluated its safety and effectiveness.


METHODS
Seventeen patients with 20 pedunculated or semipedunculated polyps with heads 1 cm or greater in diameter were treated with this technique. Conventional upper-GI endoscope, hypertonic saline-solution and epinephrine, sclerotherapy needle, and endoscopic band ligator device are needed for the procedure.


METHODS
All lesions were easily and safely resected. During this procedure, a band ligation chamber proved to be satisfactory for accurate recognition of a postpolypectomy ulcer under good visual control. No hemorrhage, perforation, or other complication occurred as a result of the use of this technique. The histologic resection margin was affected by nonneoplastic components in 6 of 20 lesions. Follow-up endoscopy 1 week later revealed a small, shallow ulcer without residual polyp in all lesions.


CONCLUSIONS
This preliminary study suggests that endoscopic resection with hypertonic saline-solution-epinephrine injection plus band ligation is a simple and effective method for the prevention of polypectomy-associated bleeding. Prospective trials, including randomized controlled studies, are required to evaluate the suitability of this modality for wide clinical use.
Akahoshi
Kazuya
K
Department of Gastroenterology and Pathology, Aso Iizuka Hospital, Iizuka, Japan.
Yoshinaga
Shigetaka
S
Fujimaru
Tatsuya
T
Kondoh
Atsushi
A
Higuchi
Naomi
N
Furuno
Tetsushi
T
Oya
Masafumi
M
D000368:Aged; D000369:Aged, 80 and over; D004338:Drug Combinations; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa; D006801:Humans; D007267:Injections; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
D004338:Drug Combinations; D012462:Saline Solution, Hypertonic; D014662:Vasoconstrictor Agents; D004837:Epinephrine