Colonoscopy and polypectomy with a side-viewing endoscope.

TY - JOUR

T1 - Colonoscopy and polypectomy with a side-viewing endoscope.

AU - Frimberger, E

AU - von Delius, S

AU - Rösch, Thomas

AU - Schmid, R M

PY - 2007

Y1 - 2007

N2 - BACKGROUND AND STUDY AIMS: Some colorectal polyps cannot be adequately viewed using forward-viewing colonoscopes because of their location behind mucosal folds or bends in the bowel. We performed polypectomy using side-viewing duodenoscopes for these problematic polyps in order to avoid incomplete polypectomy or the need for surgical intervention. PATIENTS AND METHODS: Between April 2000 and August 2003, polypectomy with a side-viewing endoscope was intended in 15 patients (seven men, eight women; mean age 63.7 years, median age 59 years, range 38-88 years) at our institution. In all these patients, polypectomy had been attempted previously with a forward-viewing colonoscope by at least one experienced endoscopist without success. The duodenoscope was advanced with slight bending of the tip to achieve a sloped forward view. RESULTS: Colorectal polyps were macroscopically completely removed in 11/15 patients. One polyp near the ileocecal valve could only be partially removed with the side-viewing endoscope; and one large flat rectal adenoma, one recurrent rectal polyp (after a previous incomplete conventional polypectomy), and one polyp near the ileocecal valve could not be removed. We observed no procedure-related complications. Endoscopic follow-up was possible in seven of the 11 patients in whom the polyps were successfully resected, with no evidence of recurrence (mean follow-up 27 months). CONCLUSIONS: Polypectomy with the side-viewing duodenoscope is a safe and effective method. It is a therapeutic option when polyps are not adequately accessible using a conventional approach.

AB - BACKGROUND AND STUDY AIMS: Some colorectal polyps cannot be adequately viewed using forward-viewing colonoscopes because of their location behind mucosal folds or bends in the bowel. We performed polypectomy using side-viewing duodenoscopes for these problematic polyps in order to avoid incomplete polypectomy or the need for surgical intervention. PATIENTS AND METHODS: Between April 2000 and August 2003, polypectomy with a side-viewing endoscope was intended in 15 patients (seven men, eight women; mean age 63.7 years, median age 59 years, range 38-88 years) at our institution. In all these patients, polypectomy had been attempted previously with a forward-viewing colonoscope by at least one experienced endoscopist without success. The duodenoscope was advanced with slight bending of the tip to achieve a sloped forward view. RESULTS: Colorectal polyps were macroscopically completely removed in 11/15 patients. One polyp near the ileocecal valve could only be partially removed with the side-viewing endoscope; and one large flat rectal adenoma, one recurrent rectal polyp (after a previous incomplete conventional polypectomy), and one polyp near the ileocecal valve could not be removed. We observed no procedure-related complications. Endoscopic follow-up was possible in seven of the 11 patients in whom the polyps were successfully resected, with no evidence of recurrence (mean follow-up 27 months). CONCLUSIONS: Polypectomy with the side-viewing duodenoscope is a safe and effective method. It is a therapeutic option when polyps are not adequately accessible using a conventional approach.

M3 - SCORING: Zeitschriftenaufsatz

VL - 39

SP - 462

EP - 465

JO - ENDOSCOPY

JF - ENDOSCOPY

SN - 0013-726X

IS - 5

M1 - 5

ER -