Endoscopic snare excision of "giant" colorectal polyps.
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Endoscopic snare excision of "giant" colorectal polyps. / Binmoeller, K F; Bohnacker, Sabine; Seifert, H; Thonke, F; Valdeyar, H; Soehendra, N.
in: GASTROINTEST ENDOSC, Jahrgang 43, Nr. 3, 3, 1996, S. 183-188.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Endoscopic snare excision of "giant" colorectal polyps.
AU - Binmoeller, K F
AU - Bohnacker, Sabine
AU - Seifert, H
AU - Thonke, F
AU - Valdeyar, H
AU - Soehendra, N
PY - 1996
Y1 - 1996
N2 - BACKGROUND: Endoscopic treatment of giant colorectal polyps remains controversial because of concerns regarding coexistent malignancy, incomplete resection, and safety. METHODS: We reviewed the clinical course after removal of 176 benign-appearing large (>3 cm) colorectal polyps, which were removed by endoscopic snare resection in 170 patients. These were termed "giant" polyps. Sessile polyps (n = 129) were removed piecemeal and pedunculated polyps (n = 47) transected at the stalk. RESULTS: Bleeding was the only complication in 24% of polypectomy procedures (procedural in 58, immediate in 3, delayed in 6 patients). Except for one conservatively treated delayed bleed, all bleeds were treated endoscopically. Histology of resected polyps showed coexistent malignancy in 12%. Eight patients had malignant polyps that met "unfavorable" criteria and underwent surgery. Following complete endoscopic resection, 16 patients were lost to follow-up and 124 patients had follow-up of at least 6 months (117 benign and 7 "favorable" malignant polyps). Nineteen patients with benign polyps developed recurrences (18 benign, 1 malignant); one patient with a favorable malignant polyp had a malignant recurrence and underwent surgery. CONCLUSION: Endoscopic resection of benign-appearing giant colorectal polyps is feasible and safe. Complete excision is possible in patients with benign and favorable malignant polyps, but recurrence rates are high. Close surveillance to detect and treat recurrence is required.
AB - BACKGROUND: Endoscopic treatment of giant colorectal polyps remains controversial because of concerns regarding coexistent malignancy, incomplete resection, and safety. METHODS: We reviewed the clinical course after removal of 176 benign-appearing large (>3 cm) colorectal polyps, which were removed by endoscopic snare resection in 170 patients. These were termed "giant" polyps. Sessile polyps (n = 129) were removed piecemeal and pedunculated polyps (n = 47) transected at the stalk. RESULTS: Bleeding was the only complication in 24% of polypectomy procedures (procedural in 58, immediate in 3, delayed in 6 patients). Except for one conservatively treated delayed bleed, all bleeds were treated endoscopically. Histology of resected polyps showed coexistent malignancy in 12%. Eight patients had malignant polyps that met "unfavorable" criteria and underwent surgery. Following complete endoscopic resection, 16 patients were lost to follow-up and 124 patients had follow-up of at least 6 months (117 benign and 7 "favorable" malignant polyps). Nineteen patients with benign polyps developed recurrences (18 benign, 1 malignant); one patient with a favorable malignant polyp had a malignant recurrence and underwent surgery. CONCLUSION: Endoscopic resection of benign-appearing giant colorectal polyps is feasible and safe. Complete excision is possible in patients with benign and favorable malignant polyps, but recurrence rates are high. Close surveillance to detect and treat recurrence is required.
M3 - SCORING: Zeitschriftenaufsatz
VL - 43
SP - 183
EP - 188
JO - GASTROINTEST ENDOSC
JF - GASTROINTEST ENDOSC
SN - 0016-5107
IS - 3
M1 - 3
ER -
