Efectiveness and safety of colonoscopic polypectomy

Abstract

<b>Introduction.</b> Colonoscopy is now widely accepted as a gold standard for detection of pre-malignant lesions, mainly adenomatous polyps. Their removal reduces the risk for colorectal cancer in patients with adenomatous polyps. <b>Aim.</b> This study aimed at evaluating the efficiency and safety of colonoscopic polypectomies which were performed between 2001 and 2007. <b>Materials and methods.</b> A retrospective analysis of the course and results of polypectomies which were performed during 2970 colonoscopies on patients admitted to hospital with symptoms of colorectal pathology. <b>Results and discussion.</b> Total colonoscopy, i.e. with caecal intubation, was performed in 2602 (91%) cases. Colonoscopic polypectomies were performed during 628 (21.5%) examinations. Single polyps were found in 346 (55.1%) cases and multiple polyps in 282 (44.9%). The total number of removed polyps amounted to 901. Out of that number 690 (76.5%) were adenomas and 173 (23.5%) presented features of the so-called advanced pathology. In 26 (2.8%) cases, the detected adenomas coexisted with colorectal cancer and were removed preoperatively. Post-polypectomy bleeding occurred in 15 (2.3%) cases but only 2 patients required surgical treatment because of the inability to stop the bleeding by an endoscopic procedure. Moreover, out of 268 rectal polyps, 19 (7%) unpedunculated polyps were removed surgically (18 of them by trans-anal excision). <b>Conclusions.</b> The effectiveness of this method was high. Polyps were detected and removed in the course of more than 20% of colonoscopic examinations. Polypectomies were relatively complications-free, although in 2 (0.28%) cases surgical treatment was necessary to stop post-polypectomy bleeding due to the inability to stop the bleeding from the polyp stalk endoscopically. Some rectal polyps (7%) had to be removed surgically. Preoperative endoscopic clearance of large bowel polyps, coexisting with neoplastic tumours, facilitated the adjustment of the resection margin in the subsequent colorectal cancer surgery.