Endoscopy 2016; 48(03): 277-280
DOI: 10.1055/s-0035-1569647
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Knife-assisted snare resection: a novel technique for resection of scarred polyps in the colon

Fergus J. Q. Chedgy
Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, United Kingdom
,
Rupam Bhattacharyya
Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, United Kingdom
,
Kesavan Kandiah
Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, United Kingdom
,
Gaius Longcroft-Wheaton
Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, United Kingdom
,
Pradeep Bhandari
Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, United Kingdom
› Author Affiliations
Further Information

Publication History

submitted30 March 2015

accepted after revision12 November 2015

Publication Date:
28 January 2016 (online)

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Background and study aims: There have been significant advances in the management of complex colorectal polyps. Previous failed resection or polyp recurrence is associated with significant fibrosis, making endoscopic resection extremely challenging; the traditional approach to these lesions is surgery. The aim of this study was to evaluate the efficacy of a novel, knife-assisted snare resection (KAR) technique in the resection of scarred colonic polyps.

Patients and methods: This was a prospective cohort study of patients, in whom the KAR technique was used to resect scarred colonic polyps > 2 cm in size. Patients had previously undergone endoscopic mucosal resection (EMR) and developed recurrence, or EMR had been attempted but was aborted as a result of technical difficulty.

Results: A total of 42 patients underwent KAR of large (median 40 mm) scarred polyps. Surgery for benign disease was avoided in 38 of 41 patients (93 %). No life-threatening complications occurred. Recurrence was seen in six patients (16 %), five of whom underwent further endoscopic resection. The overall cure rate for KAR in complex scarred colonic polyps was 90 %.

Conclusions: KAR of scarred colonic polyps by an expert endoscopist was an effective and safe technique with low recurrence rates.