Insulated Tip Knife Endoscopic Polypectomy for Difficult Pedunculated Colorectal Polyps: A Prospective Pilot Study

Abstract

Introduction: Endoscopic polypectomy is widely used for colorectal polyps. However, for giant pedunculated colorectal polyps (≥3 cm), conventional techniques are so difficult with en bloc resection that patients had to be transferred to surgery.We had firstly reported our first experience with an insulatedtip knife to successfully remove a giant pedunculated polyp in the sigmoid colon. In this study, our aim was to explore safety and feasible of insulated-tip knife endoscopic polypectomy (IT-EP) for difficult pedunculated colorectal polyps. Methods: A total of seven consecutive patients with giant pedunculated colorectal polyps (≥3 cm) were prospectively enrolled.IT-EP was conducted with the help of clips for all theseven patients, and data of them was recorded and analyzed. Results: Of seven patients, five were men and two were women with a mean age 61 years (49-72 years). The mean diameter of polyp head and stalk was (36.4±4.9)mm (30-42)mm and (14.6±3.6)mm (10-20) mm,respectively.All the polyps were successfully removedwith IT-EP, with amean operation time of (14.9±3.5)min (11-20) min. No serious bleeding or perforation was experienced, and no surgery was needed. There was no recurrence or residual of polyps at amean 8.1-month follow-up. Conclusion: Insulated-tip knife endoscopic polypectomy is a safe and feasible alternative for difficult pedunculated colorectal polyps.