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CC BY 4.0 · Endosc Int Open
DOI: 10.1055/a-2788-3249
Original article

Resection of large, broad-based pedunculated and semi-pedunculated colorectal polyps using a scissor-type endoscopic submucosal dissection knife

Autor*innen

  • Robert Eckersley

    1   Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute, London, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN105692)

  • Noriko Suzuki

    1   Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute, London, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN105692)

  • Brian Saunders

    1   Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute, London, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN105692)

  • Adam Humphries

    1   Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute, London, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN105692)
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Background and study aims: Endoscopic resection of large, broad-based pedunculated and semi-pedunculated polyps can be technically difficult. Conventional snare resection risks immediate bleeding and piecemeal excision. We evaluated the safety and efficacy of a scissor-type endoscopic submucosal dissection (ST-ESD) knife for these lesions. Patients and methods: A single-center retrospective study was conducted of all patients who underwent ST-ESD resection of pedunculated or semi-pedunculated polyps with head size ≧ 20 mm and stalk width ≧ 10 mm. Primary outcomes were en bloc resection, intraprocedural and delayed bleeding, and perforation. Secondary outcomes were R0 resection and recurrence at first follow-up. Results: Fifty-eight resections were identified (75.6% male; median age 60 years). Median head size was 30 mm (range 20-70) with median stalk width 15 mm (range 10-50). Of them, 74.1% were in the sigmoid colon. Successful resection was achieved in 52 of 58 (89.7%); 44 (75.9%) by ST-ESD alone and eight (13.8%) snare-assisted. Six (10.3%) were abandoned; five due to visible muscle retraction and one dense stalk fibrosis. All successful resections were en bloc with R0 in 52 of 52 (100%). Minor intraprocedural bleeding occurred in nine of 58 (15.5%) and was controlled endoscopically. Forty-seven of 52 defects (90.4%) were closed prophylactically with endoscopic clips. There were no incidences of delayed bleeding or perforation. Histopathology was benign in 51 of 52 (98.1%). One adenocarcinoma was treated surgically for high-risk features. Endoscopic follow-up was available in 41 of 52 (78.8%) with no recurrence seen. Zero of six abandoned cases referred for surgery contained evidence of malignancy in the surgical specimen. Conclusions: ST-ESD is safe and effective for resection of large, broad-based pedunculated and semi-pedunculated colorectal polyps.



Publikationsverlauf

Eingereicht: 09. Oktober 2025

Angenommen nach Revision: 13. Januar 2026

Accepted Manuscript online:
15. Januar 2026

© . The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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Bibliographical Record
Robert Eckersley, Noriko Suzuki, Brian Saunders, Adam Humphries. Resection of large, broad-based pedunculated and semi-pedunculated colorectal polyps using a scissor-type endoscopic submucosal dissection knife. Endosc Int Open ; 0: a27883249.
DOI: 10.1055/a-2788-3249