Colonoscopic Polypectomy - Evaluation of the Effectiveness and Safety (Single Center Experience)

Abstract

Colonoscopy is currently accepted as the golden standard in the detection of pre-malignant lesions, and reduction of the incidence of colorectal cancer in patients with adenomatous polyps. the aim of the study was to determine the diagnostic value of colonoscopy in case of patients with clinical symptoms suggesting the possibility of colorectal pathology, as well as evaluate the technical aspects and results of colonoscopic polypectomies, considering the efficacy and safety of the abovementioned procedures. Material and methods. Retrospective analysis of the course and results of the polypectomies performed during 3638 colonoscopies was undertaken, considering patients with suspicion of colorectal pathology. Results. Complete colonoscopy with cecal intubation was performed in 3310 (91%) cases. Colonoscopic polypectomies were performed during 806 (22.1%) examinations. Single polyps were detected in 459 (56.9%) cases, while multiple lesions in 347 (43.1%) cases. The total number of removed polyps amounted to 1184. There were 882 (74.6%) adenomas of which 225 (25.5%) were considered as an advanced pathology. Moreover, the pathologist detected 4 malignant polyps with features of adenocarcarcinoma. In case of 30 examinations, adenomas coexisted with colorectal cancer and were removed preoperatively. Post-polypectomy bleeding was observed after 15 (1.7%) polypectomies, although only two patients required surgery. Moreover, amongst the 343 rectal polyps, 19 (6%) non-pedunculated lesions were surgically removed (18 of them by means of the trans-anal approach). conclusions. The method proved effective and the polyps were detected and removed in more than 22% of the colonoscopic examinations. In two (0.28%) cases surgical intervention was required, in order to stop post-polypectomy bleeding from the polyp's peduncle. Some of the rectal polyps (6%) had to be surgically removed. Preoperative endoscopic "clearance" of large bowel polyps, facilitated the adjustment of the resection margin in subsequent colorectal cancer surgery.