A CASE CONTROLLED STUDY TO COMPARE A CONVENTIONAL ELECTROSURGICAL GENERATOR TO ONE WITH ENDOCUT® IN PERFORMING SNARE POLYPECTOMY

Abstract

Purpose: There are no previous studies comparing safety of electrosurgical generators (ESG) in performing snare polypectomy. Furthermore, there are no studies looking at the use of Endocut® in performing snare polypectomy. We conducted a retrospective case controlled study to compare a conventional ESG to a newer ESG with the Endocut® feature. Methods: At our institution, a conventional ESG utilizing blended current was used for all snare polypectomies up to February 28, 2001. A retrospective case controlled chart review was performed of all patients undergoing colonoscopy from August 27, 1999 through September 9, 2002. The inclusion criteria encompassed all patients who underwent snare polypectomy during colonoscopy performed for the usually recommended indications. Data collection included patient demographics, number of polyps removed, polyp characteristics, immediate and delayed complications related to the polypectomy. The case controls consisted of 150 cases that underwent snare polypectomy using the conventional ESG prior to February 28, 2001. After this date, 150 consecutive cases that underwent snare polypectomy with the newer ESG utilizing blended current with the Endocut® feature were also analyzed. All polypectomies were performed using the same type of monopolar snare with standard manufacturer recommended settings. Results: A total of 311 polyps were excised with the conventional ESG of which 255 were removed with snare. Average size of the polyps was 7.4 mm. In this group, there were 4 (2.67%) complications. All complications were post polypectomy bleeds; 2 immediate and 2 delayed. In the newer ESG with Endocut® group, 375 polyps were removed of which 263 were excised using snare. Average size of the polyps was 7.6 mm. In this group, there was 1 (0.67%) post polypectomy bleed. The groups did not differ significantly in their demographics, comorbid conditions or polyp characteristics. Conclusions: In our study, the newer ESG with the Endocut® feature did not provide statistically significant clinical benefit in complication rates (P = 0.22). This can be explained by the limited sample size. The data does lean towards statistical importance warrenting further study. A prospective randomized trial using larger number of patients may show statistically significant benifit in the complication rates of one ESG over the other.