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Endoscopy 2021; 53(01): 77-80
DOI: 10.1055/a-1194-4413
Innovations and brief communications

Endoscopic submucosal dissection of large pedunculated polyps with wide stalks: a retrospective multicenter study

Hideyuki Chiba
1   Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan
,
Jun Tachikawa
1   Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan
,
Jun Arimoto
1   Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan
,
Keiichi Ashikari
2   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
,
Hiroki Kuwabara
1   Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan
,
Michiko Nakaoka
1   Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan
,
Toru Goto
1   Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan
,
Takuma Higurashi
2   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
,
Takashi Muramoto
3   Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo, Japan
,
Ken Ohata
3   Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo, Japan
,
Atsushi Nakajima
2   Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
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Author commentary on Hideyuki Chiba et al.Endoscopy 2021; 53(01): v5-v5
DOI: 10.1055/a-1195-4426

Abstract

Background Endoscopic resection of large pedunculated colorectal polyps is technically difficult, especially when the polyp is large and has such a thick stalk that it is either too difficult or impossible to resect prophylactically by a conventional snare. Here, we evaluated the feasibility of ESD for large pedunculated polyps with wide stalks.

Methods 29 patients with large pedunculated polyps that were not resectable by polypectomy or endoscopic mucosal resection were enrolled in the study.

Results En bloc resection was achieved in 28/29 polyps. One suspended case was due to severe fibrosis with muscle retraction signs. The mean diameter of the 29 polyp heads was 39.7 (standard deviation 6.9) mm. Submucosal fibrosis was present in 16 polyps (9 mild; 7 severe). The stalks of severely fibrotic polyps were significantly thicker than those of polyps with no or mild fibrosis. The curative resection rate was 85.7 % without severe complications.

Conclusions ESD is feasible for the removal of large pedunculated polyps with wide stalks when conventional snare resection is difficult or impossible.

Supplementary material



Publication History

Received: 02 February 2020

Accepted: 15 May 2020

Article published online:
09 July 2020

© 2020. Thieme. All rights reserved.

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