7081 A new high frequency(hf)current generator with automatically controlled system (endocut)for endoscopic polypectomy of the colon.

Abstract

Background:major complications of polypectomy are bleeding and perforation with combined incidence of approximately 1.7% (perforation 0.04 to 2.1% and bleeding 0.3 to 2%).Recently a new HF generator providing automatically controlled cut system (Endocut) showed good results in endoscopic biliary sphincterotomies, with reduced risk of bleeding. Aim of the study:to assess the effectiveness and safety of this new device in endoscopic colonic polipectomy. Material and methods: from Sept'97 to Nov'99 260 consecutive polypectomies were performed in 177 patients (M97, F80)with the newly developed HF surgery unit (Erbotom ICC 200 Erbe, Tubingen, Germany). The unit was set for Endocut, Effect 3 (output limit 120W).Polyps were located in the:rectum n=50;sigmoid n=80;descending n=32; splenic flexure=8; transverse n=44; right flexure n=11; ascending n=30; cecum n=5. Pedunculated n=65(25%), sessile n=195(75%).Histology showed:adenoma:186 (tubular n=103; villous n=21; tubulovillous n=62); hyperplastic n=65; adenocarcinoma n=9 (in situ n=2). Mean diameter of polyps was 9 mm (range 3-40 mm). Twenty three polyps (8.8%) were >2 cm.Results: no perforation and postpolypectomy coagulation syndrome were observed; bleeding rate was 1.9& (n=5). All bleeding could be treated endoscopically: APC n=3; regrasping with snare and APC n=1; epinephrine+endoloop+APC n=1. All but one bleeding were observed in polyps >2cm.(4/23=17.3%;1:237=0.4% p