title: Use of dual knife for large pedunculated colorectal polyps.
abstract: BACKGROUND
  Endoscopic resection of large pedunculated colorectal polyps is technically difficult, especially when the polyps are so large that it is either not possible or too difficult to resect them using a conventional polypectomy snare.
  
  
  OBJECTIVE
  To facilitate the removal of pedunculated colorectal polyps, we developed a new technique using a combination of a dual knife and preventive hemostatic procedures.
  
  
  METHODS
  Nine patients (5 men and 4 women; mean age, 59.8 y; range, 49 to 79 y) with pedunculated polyps >2 cm in diameter were treated with this technique. A dual knife and endoclips or an endoloop were used as needed.
  
  
  RESULTS
  All lesions, except for 1 polyp, were resected endoscopically. The mean time for complete resection was 8.5 minutes (range, 1.5 to 16 min). The procedure time decreased significantly after the fifth case (168 vs. 746 s, P=0.0009). No hemorrhage, perforation, or other complications occurred during follow-up among the endoscopically resected cases.
  
  
  CONCLUSIONS
  Combined use of a dual knife and prophylactic hemostatic procedures is a feasible alternative technique for removing large pedunculated colorectal polyps when conventional snare resection is impossible or difficult.
authors.affiliation: *Department of Gastroenterology, Changhua Christian Hospital, Changhua †School of Medicine, Chung-Shan Medical University, Taichung City ‡Department of Gastroenterology, China Medical University Hospital, Taichung City, Taiwan.
authors.forename: Chia-Wei
authors.initials: CW
authors.lastname: Yang
authors.forename: Hsu-Heng
authors.initials: HH
authors.lastname: Yen
authors.forename: Yang-Yuan
authors.initials: YY
authors.lastname: Chen
authors.forename: Maw-Soan
authors.initials: MS
authors.lastname: Soon
mesh_terms: D000368:Aged; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D005260:Female; D006489:Hemostatic Techniques; D006801:Humans; D007417:Intestinal Polyps / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery; D013525:Surgical Instruments