Submucosal Saline-Epinephrine Injection in Colonoscopic Polypectomy: What is the Proper Application?.
- Author:
Sang Huyb LEE
1
;
Kyoung Soo LEE
;
Yeol Keun WOO
;
Byong Duk YE
;
Jong Yeul LEE
;
Su Cheol PARK
;
Kwang Hyuck LEE
;
Young Soo PARK
;
Jin Hyeok HWANG
;
Sook Hyang JUNG
;
Nayoung KIM
;
Dong Ho LEE
;
Sang Gyun KIM
;
Joo Sung KIM
;
Hyun Chae JUNG
;
In Sung SONG
Author Information
1. Liver Research Institute and Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Polypectomy;
Complications;
Submucosal Injection
- MeSH:
Adenoma
- From:Korean Journal of Gastrointestinal Endoscopy
2006;33(2):77-84
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Indications for submucosal saline-epinephrine injection (SSEI) for prevention of postpolypectomy bleeding, in the colon, is variable among endoscopists. The aim of this study was to determine the proper indication for SSEI. METHODS: Clinical data of 1,745 polypectomies was evaluated. Postpolypectomy bleeding after snare polypectomy were evaluated in 1,039 polypectomies. Subgroup analysis was performed in 4 subgroups by size (< or = 8 mm or >8 mm) and gross morphology (pedunculated or sessile), also. RESULTS: Submucosal saline-epinephrine injection was used in 679 snare polypectomies. The size of polyps was 9.5+/-4.3 mm. Distribution of polyps showed left side shift in the colon. Sessile polyps (79.4%) and benign adenoma (75.3%) were predominant. Twenty seven episodes (2.6%) of bleeding occurred after snare polypectomy. Rectal polyp, malignant polyp and procedure without SSEI increased bleeding after snare polypectomy with odds ratio 4.71, 10.48 and 3.44, respectively. However, SSEI significantly reduced the bleeding only in patients who had >8 mm sized sessile polyps with odds ratio 16.41 regardless of location and histopathology. CONCLUSIONS: SSEI should be performed in colonoscopic snare polypectomy for >8 mm sized sessile polyps, and might be performed in others for prevention of bleeding at the discretion of the clinician.
