Using of endoscopic band ligation for endoscopic removal of colonic polyps

Abstract

BACKGROUND. Intraand postoperative colonic bleeding is the most frequent complication in endoscopic removal of large colonic polyps. In this article, one of the methods of preventing this complication is discussed – preliminary preventive ligation of the leg of the polyp, carried out by using an endoscopic loop ligation.METHODS AND MATERIALS. The prospective trial provided between March and September 2023. This trial included 38 patients with 39 colonic polyps with the feeding leg of the polyp non-less than 5 mm in diameter. All patients underwent endoscopic mucosal resection within the leg of the polyp with preliminary preventive ligation of the leg. The ligation provided by the device inserted through the instrumental channel of the endoscope, and allowing delivery and tightening of the non-dissolving Rцder’s loop on the leg of the polyp.RESULTS. All identified polyps were successfully removed. The radicality of the removal was confirmed by histological examination data. The occurrence of technical difficulties during removal was noted in one case when removing the polyp 4 cm in diameter. The appeared technical difficulties were associated with difficult visualization of the feeding leg of the polyp, which was due to the large size of the removed formation. Positive correlation between the forma tion size and surgery time was observed (Spearman p=0.52, P=0.034). There were no bleeding complications during operations and early postoperative period.CONCLUSION. Preliminary preventive ligation is a simple, effective and safe method to prevent bleeding when remov ing polyps of the mucous membranes of the gastrointestinal tract.