Multiband mucosectomy for the treatment of challenging non-pedunculated colorectal polyps.

Abstract

Endoscopic mucosal resection is the gold standard treatment for non-pedunculated colorectal polyps; however, some specific situations (location behind folds, scarred or flat morphology) can make this technique challenging. We aimed to assess the efficacy and safety of multiband mucosectomy (MBM) for resection of non-pedunculated colorectal polyps. This was a retrospective study of patients in whom MBM was performed to resect large non-pedunculated colorectal polyps. All procedures were carried out using the Shooter multiband ligator kit (Cook Medical, Limerick, Ireland). A 3-month follow-up colonoscopy was performed in all patients. 10 patients underwent MBM for resection of 10 large (median 33.5 mm) non-pedunculated polyps. A total of 45 MBM sessions were carried out to resect all of the lesions using on average one rubber band per 1.5 cm2 of resected tissue. Complete resection was possible in 9 out of 10 lesions, although en bloc resection was only feasible in one lesion. Follow-up colonoscopy revealed residual adenoma in just one patient. No major complications were registered. In this small series of patients, MBM proved to be a safe and effective endoscopic resection technique for challenging non-pedunculated colorectal polyps.