Removal Of Pedunculated Polyps Research Articles

7085 Preventive clipping following bipolar snare removal of pedunculated colonic polyps.

PURPOSE : Bipolar snares minimize tissue damage, but are not used generally for colonic polypectomy in Japan, probably because increased risk of bleeding reflecting insufficient coagulation is suspected. Since clipping has been reported to be useful in preventing bleeding after monopolar snare polypectomy, we sought to determine whether clipping can prevent bleeding in removal of pedunculated polyps using the bipolar snare. METHODS: We studied patients whose colonic lesions were pedunculated polyps=5 mm in diameter and endoscopically appeared confined to the mucosal layer.We performed bipolar snare polypectomy and added preventive clipping to clamp the stump immediately after polypectomy even when no bleeding was encountered.We assessed retrospectively the histologic diagnosis of the resected specimen, the completeness of polypectomy, and the occurrence of bleeding and perforation. RESULTS : Between April 1997 and March 1999, we evaluated 11 lesions in 10 patients. 11 pedunculated polyps (diameter of head, 10.0 ± 4.1 mm) were resected completely. Histologically, 10 lesions were purely adenoma while 1 contained focal admocarcinoma that arose in the adenoma but was confined to the mucosa. Technical success with clipping was achieved in all cases. No postpolypectomy bleeding, perforation, or complications from dipping occurred. CONCLUSIONS :We found clipping to be effective in preventing bleeding after bipolar snare removal of pedunculated colonic polyps. A bipolar snare which has the advantage of shallow tissue damage can be employed safely by using preventive clipping.

A Newly Developed Therapeutic Laryngofiberscope

In recent years, the definite diagnosis of laryngeal diseases with a minimized discomfort to the patient has become possible by frequent use of flexible laryngofiberscopes. However, there have been difficult cases for an endoscopic examination even by this type of flexible laryngofiberscope because of visual disturbance due to hypersecretion. And also the collection of specimens for histological examination and the therapeutic procedures such as the removal of pedunculated polyps and suction of secretion have not been achieved with the current diagnostic fiberscopes.Therefore, we have taken those problems into consideration, and recently developed a new therapeutic laryngofiberscope.We introduce this new fiber-laryngoscope for therapy with its specifications and procedures, and make a clinical report on 6 cases which we have successfully performed endoscopic examinations and therapeutic manipulations with this instrument.