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DOI: 10.1055/s-0039-1681808
ENDOSCOPIC RESECTION OF SMALL COLORECTAL POLYPS: WHAT IS THE OPTIMAL TECHNIQUE?
Publication History
Publication Date:
18 March 2019 (online)
Aims:
More than 70% of the polyps detected during colonoscopies are small (1 – 10 mm). The optimal technique of their complete resection is a subject of concern for endoscopists.
The aim of this study was to review the different techniques used for the resection of small polyps and to suggest which one would be most effective comparing the different rates of incomplete resection.
Methods:
This was a retrospective study including all the patients who underwent polypectomy for a small colorectal polyp during a period of 12 months (the year 2017). Three groups were defined: Group 1 (G1) for polyps resected using mucosectomy, group 2 (G2) for polyps resected using hot snare and group 3 (G3) for polyps removed by the biopsy forceps.
Results:
During the year of the study, 116 colorectal polypectomies were performed for 74 patients with an average age of 62 years [22.87 years] and a sex ratio (M/F) of 2.08. Polyps at mainly in the rectum (29.3%). They were sessile in 76.7% (n = 89), pedunculated in 10.3% (n = 12), and flat in 8.6% of cases (n = 10). The average size of polyps was 4.59 mm [2 – 10]. Diminutive polyps were prevailing (71.5% of cases, n = 83). The histopathological assessment showed that 25.8% of the polyps were hyperplastic (n = 30), while 66.4% (n = 77) were adenomatous. In the latter, 80.5% were tubular and 16.6% tubulovillous. G1 included 16 polyps, G2: 15 polyps and G3: 82 polyps. The incomplete resection rate of adenomatous polyps was significantly higher in G3 compared to G2 and G1 (23.1% vs. 6.6% vs. 18.7%, p = 0.12).
Conclusions:
In our serie, complete endoscopic resection of small polyps was much better using hot snare. Untill today, no optimal method has been described for the resection of small polyps.