Background/Aims: The removal of small colon polyps by hot snare polypectomy (HP) is a commonly used method. Polypectomy with a cold snare (CP) has been increasingly utilized in recent years. Each method has its own advantages and disadvantages. Herein, we explored the efficacy and safety of each method. Materials and Methods: Between January 1, 2012 and June 30, 2012, 97 consecutive patients with small colorectal polyps ranging from 5-9 mm in size were separated into either the CP or HP group. Demographic data, the duration of polypectomy, and pathology reports were recorded. Results: Seventy-seven polyps were removed from 49 patients in the CP group, and 71 polyps were removed from 48 patients in the HP group. There was no significant difference between the groups with respect to gender, age distribution, number of polyps, or indications for colonoscopy. The mean polyp size was 7.21±1.4 mm in the CP group and 7.56±1.45 mm in the HP group (p=0.111). There was a significant difference in the mean procedure time between the two groups (CP, 25.71±4.3 sec; HP, 70.28±11.3 sec, p<0.001). One patient (1.3/1.4%) from each group developed post-polypectomy bleeding that required treatment. Histological evaluation revealed that 10 of the polyps (6.75%) were advanced adenomas. Pathological examination showed that the polyps were not completely removed in 4 patients (5.13%) in the CP group and 4 patients (5.63%) in the HP group (p=0.89). Conclusion: CP is an effective and safe method that shortens the polypectomy duration in small polyps (≤9 mm) compared to HP.
RFITT is efficacious, well tolerated by patients and has a low incidence of procedure-related post-operative complications.
For the first time efficacy and safety of a new prostaglandin E1 (PGE1) regimen in the treatment of intermittent claudication were evaluated in a randomized, double-blind, placebo-controlled multicenter clinical trial. The study involved 213 outpatients with a maximum walking distance of 50 to 200 m measured on the treadmill (3 km/hr, 12% grade). After a 2-week run-in phase they received a 2-hour intravenous infusion of 60 micrograms PGE1 or placebo 5 days a week for 4 weeks. It was followed by a 4-week interval treatment with the same medication administered only twice a week. Patients were monitored for 3 months when they received no study medication. In the PGE1 group the intention-to-treat analysis (n = 208) revealed an increase in walking distance after 4 weeks of 75% (placebo, 43%). At the end of the interval treatment the walking distance had improved to 101% (placebo, 60%). The results remained virtually constant during follow-up (PGE1, 104%, placebo, 63%). Between-group comparisons showed significant differences in favor of PGE1 for all three time points of measurement (p < 0.05, p < 0.01, and p < 0.05). PGE1 was well tolerated; the rate of adverse reactions related to the treatment was 12.8% (placebo, 7.7%). In summary, these results show that the new PGE1 regimen is effective and safe in the treatment of outpatients with intermittent claudication.
Different methods such as standard, hot, and jumbo forceps are used in endoscopic treatment of diminutive colon polyps. In the current study, it was aimed to compare efficacy and safety of standard and jumbo forceps polypectomy methods in treatment of diminutive colon polyps of ≤5 mm. Polyps with ≤5 mm which were excised during colonoscopy by using standard or jumbo forceps were evaluated. Standard and jumbo forceps polypectomy methods were randomly performed in 212 consecutive patients with diminutive colorectal polyp. One-bite polypectomy and complete resection rates were also determined among polypectomy methods. Results of 161 standard forceps polypectomy and 102 jumbo forceps polypectomy were retrospectively evaluated. Both one-bite polypectomy and complete resection rates were significantly higher in the jumbo forceps polypectomy group than the standard forceps polypectomy group (P < 0.001). In the subgroup analysis performed according to polyp sizes, complete resection rate among polyps with 3mm diameter was determined as 100%. However, numbers of bites in 4-mm and 5-mm polyps were higher in the standard forceps polypectomy group, and complete resection rate was lower than in the jumbo forceps polypectomy group (P < 0.001). Both endoscopic treatment methods may be employed in treatment of diminutive colon polyps with ≤5 mm. However, jumbo forceps polypectomy is a more effective treatment method in 4- to 5-mm polyps with high one-bite polypectomy and complete resection rate.
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