Clinical Endoscopy

Original Articles

Depth of noninjecting resection using bipolar soft coagulation mode for 6 to 9 mm colorectal polyps: a retrospective study in Japan: Yoshifumi Watanabe, Mitsuo Tokuhara, Hidetoshi Nakata, Hiroko Nakahira, Ikuko Torii, Yasumasa Sumitomo; Clin Endosc 2026;59(1):115-123. Published online December 18, 2025; DOI: https://doi.org/10.5946/ce.2025.100

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: Endoscopic resection of colorectal polyps reduces mortality from colorectal cancer. We report here a novel resection method, known as noninjecting resection using bipolar soft coagulation mode (NIRBS), and assess its feasibility. This study aimed to compare the resection depth achieved with NIRBS to those achieved with cold snare polypectomy (CSP) and conventional endoscopic mucosal resection (CEMR).
Methods
Patients with 6 to 9 mm colorectal polyps underwent endoscopic resection at Hoshigaoka Medical Center between October 2023 and January 2024. We analyzed the thickness of resected submucosal tissue following the use of NIRBS, CSP, and CEMR.
Results
We identified 95 polyps, including adenomas and serrated lesions. The proportions of specimens containing submucosal tissue were 21.4%, 100.0%, and 97.9% in CSP, CEMR, and NIRBS, respectively. The median submucosal tissue thickness for CEMR and NIRBS was 1,167 and 1,125 µm, respectively, which was significantly greater than 0 µm for CSP. For NIRBS, the median thickness was 1,140 and 1,017 µm for the expert and non-expert endoscopists, respectively.
Conclusions
The depth of submucosal resection with NIRBS exceeded 1,000 μm regardless of endoscopist experience. NIRBS can be a useful resection method for patients with colorectal polyps, including those with non-submucosally invasive carcinomas.

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Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial: Ramona Schiumerini, Paola Baccarini, Adele Fornelli, Davide Allegri, Francesca Lodato, Alessia Gazzola, Pasquale Apolito, Nunzio P. Longo, Anna M. Polifemo, Franca Patrizi, Federica Buonfiglioli, Stefania Ghersi, Marco Bassi, Liza Ceroni, Antonella Ghetti, Giulio Fonti, Vincenzo Cennamo; Clin Endosc 2025;58(2):291-302. Published online February 24, 2025; DOI: https://doi.org/10.5946/ce.2024.113

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: Small polyps are the most frequently detected lesions during colonoscopy, with an incomplete resection rate of 6.8% to 15.9%. This study aimed to improve small polyp cold snare resection radicality using submucosal contrast dye pre-lifting (PL+CSP).
Methods
This single-center, prospective, randomized controlled trial compared the standard cold snare polypectomy technique (PL-CSP) with PL+CSP to evaluate endoscopic and histological complete resection rates, adverse events, procedural times, and polyp retrieval failure rates.
Results
In 143 patients consecutively enrolled, 186 small polyps were detected and randomly assigned following a 1:1 ratio to the PL-CSP (n=97, 51.6%) and PL+CSP (n=90, 48.4%) techniques. Endoscopic (p=0.97) and histologic (p=0.23) complete resection rates did not differ significantly even in univariate analysis. The intraprocedural bleeding rate was significantly higher in the PL+CSP group as confirmed by the univariate analysis (35.8% vs. 8.3%, p<0.001). The polyps retrieval failure rates were similar (p=0.83). Procedural time was significantly longer for PL+CSP (median time, 75 vs. 45 seconds; p<0.001), without impacting colonoscopy withdrawal time (p=0.215).
Conclusions
PL+CSP of small polyps did not improve endoscopic and histological complete resection rates and polyp sample retrieval. PL+CSP had higher rates of intraprocedural bleeding and was “time-consuming”.

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Review

Post-polypectomy colorectal bleeding: current strategies and the way forward: Nilanga Nishad, Mo Hameed Thoufeeq; Clin Endosc 2025;58(2):191-200. Published online November 27, 2024; DOI: https://doi.org/10.5946/ce.2024.241

Abstract PDF PubReader ePub

Post-endoscopic mucosal resection (EMR) bleeding, or clinically significant post-EMR bleeding, is influenced by factors such as polyp size, right-sided colonic lesions, laterally spreading tumors, anticoagulant use, and comorbidities like cardiovascular or chronic renal disease. The optimal prophylactic therapy for post-EMR bleeding remains unknown, with no consensus on specific criteria for its application. Moreover, prophylactic measures, including clipping, suturing, and coagulation, have produced mixed results. Selective clipping in high-risk patients is cost-effective, whereas universal clipping is not. Studies and meta-analyses indicate that routine prophylactic clipping does not generally reduce post-polypectomy bleeding but may be beneficial in cases of large proximal lesions. Some studies have revealed that the post-polypectomy bleeding risk after EMR of transverse colonic lesions is lower than that of the ascending colon and caecum, suggesting limited efficacy of clipping in the transverse colon. Cost-effectiveness studies support selective clipping in high-risk groups, and newer static agents such as PuraStat are alternatives; however, their cost-effectiveness is undetermined. Further research is required to establish clear guidelines and refine prophylactic strategies to prevent post-EMR bleeding.

Citations

Citations to this article as recorded by

Prophylactic clipping versus no clipping after endoscopic mucosal resection of large nonpedunculated colon polyps: a cost-effectiveness analysis
Sneh Sonaiya, Raj Patel, Charmy Parikh, Magnus Chun, Amrit Narwan, Karan Yagnik, Pranav Patel, Bradley Confer, Harshit Khara, Babu P. Mohan
Gastrointestinal Endoscopy.2026; 103(3): 494. CrossRef
Iatrogenic colon perforation: endoscopic management or surgery
Seung Bum Lee
Clinical Endoscopy.2026; 59(1): 33. CrossRef
Distinct Clinical and Outcome Profiles Across Six Subtypes of Acute Gastrointestinal Bleeding: A Comprehensive Analysis of 1021 Patients
Nóra Vörhendi, Levente Frim, Orsolya Anna Simon, Eszter Boros, Brigitta Teutsch, Dániel Pálinkás, Edina Tari, Dávid Berki, Patrícia Kalló, Edina Ecsedy, Endre Botond Gagyi, Armand Csontos, Zoltán Sipos, Nelli Farkas, Áron Vincze, Ferenc Izbéki, Andrea Sze
Journal of Clinical Medicine.2026; 15(5): 1998. CrossRef
Over-the-Scope Clip vs Standard Endoscopic Therapy as First-Line Intervention for Nonvariceal Upper Gastrointestinal Bleeding: A Cost-Effectiveness Analysis
Sneh Sonaiya, Sahib Singh, Tooba Laeeq, Vaishnavi Modi, Magnus Chun, Pranav Patel, Vignan Manne, Babu P. Mohan
Techniques and Innovations in Gastrointestinal Endoscopy.2025; 27(4): 250935. CrossRef
Cold snare polypectomy versus hot snare polypectomy for small pedunculated polyps: a cost-effectiveness analysis
Sneh Sonaiya, Raj Patel, Dushyant Singh Dahiya, Shahryar Khan, Charmy Parikh, Mark Stasiewicz, Pranav D. Patel, Kyaw Min Tun, Bradley Confer, Harshit S. Khara, Sumant Inamdar, Vignan Manne, Babu P. Mohan, Douglas G. Adler
Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Cold Versus Hot Endoscopic Mucosal Resection for ≥15 mm Large Nonpedunculated Colorectal Polyps
Sneh Sonaiya, Dushyant S. Dahiya, Raj Patel, Shahryar Khan, Charmy Parikh, Karan Yagnik, Chun-Han Lo, Kyaw Min Tun, Pranav D. Patel, Bradley Confer, Harshit S. Khara, Sumant Inamdar, Babu P. Mohan
Journal of Clinical Gastroenterology.2025;[Epub] CrossRef

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Systematic Review and Meta-analysis

Cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps: a meta-analysis of randomized controlled trials: Vishali Moond, Priyadarshini Loganathan, Sheza Malik, Dushyant Singh Dahiya, Babu P. Mohan, Daryl Ramai, Michele McGinnis, Deepak Madhu, Mohammad Bilal, Aasma Shaukat, Saurabh Chandan; Clin Endosc 2024;57(6):747-758. Published online August 23, 2024; DOI: https://doi.org/10.5946/ce.2024.081

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Cold snare polypectomy (CSP) is routinely performed for small colorectal polyps (≤10 mm). However, challenges include insufficient resection depth and immediate bleeding, hindering precise pathological evaluation. We aimed to compare the outcomes of cold endoscopic mucosal resection (CEMR) with that of CSP for colorectal polyps ≤10 mm, using data from randomized controlled trials (RCTs).
Methods
Multiple databases were searched in December 2023 for RCTs reporting outcomes of CSP versus CEMR for colorectal polyps ≤10 mm in size. Our primary outcomes were rates of complete and en-bloc resections, while our secondary outcomes were total resection time (seconds) and adverse events, including immediate bleeding, delayed bleeding, and perforation.
Results
The complete resection rates did not significantly differ (CSP, 91.8% vs. CEMR 94.6%), nor did the rates of en-bloc resection (CSP, 98.9% vs. CEMR, 98.3%) or incomplete resection (CSP, 6.7% vs. CEMR, 4.8%). Adverse event rates were similarly insignificant in variance. However, CEMR had a notably longer mean resection time (133.51 vs. 91.30 seconds).
Conclusions
Our meta-analysis of seven RCTs showed that while both CSP and CEMR are equally safe and effective for resecting small (≤10 mm) colorectal polyps, the latter is associated with a longer resection time.

Citations

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Recent advancement in size measurement during endoscopy
Hye Kyung Jeon, Gwang Ha Kim
Clinical Endoscopy.2026; 59(1): 1. CrossRef
Does the size of the cold snare affect the outcome of cold snare polypectomy in the colon? A KASID prospective multicenter study
Seongwoo Choi, Jaeyoung Chun, Geunhyuk Choi, Yoojin Lee, Taegeun Gweon, Yunho Jung
Intestinal Research.2026; 24(1): 76. CrossRef
Iatrogenic colon perforation: endoscopic management or surgery
Seung Bum Lee
Clinical Endoscopy.2026; 59(1): 33. CrossRef

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Original Article

Endoscopic management of giant colonic polyps: a retrospective Italian study: Paolo Quitadamo, Sara Isoldi, Germana De Nucci, Giulia Muzi, Flora Caruso; Clin Endosc 2024;57(4):501-507. Published online June 5, 2024; DOI: https://doi.org/10.5946/ce.2023.229

Graphical Abstract Abstract PDF PubReader ePub

Background
/Aims: Polyps greater than 30 mm are classified as “giants”. Their endoscopic removal represents a technical challenge. The choice of the endoscopic removal technique is important because it provides a resection sample for precise histopathological staging. This is pivotal for diagnostic, prognostic, and management purposes.
Methods
From a retrospective analysis, we obtained a sample of 38 giant polyps. Eighteen polypectomies were performed using the epinephrine volume reduction (EVR) method, nine polypectomies utilized endo-looping or clipping methods, and 11 patients underwent surgery.
Results
We obtained en bloc resection with the EVR method in all cases; histology confirmed the correct indication for endoscopic resection in all cases. Moreover, no early or delayed complications were observed, and no patient required hospitalization. Using endo-looping or clipping methods, we observed advanced histology in 1/9 (11.1%) cases, while another patient (1/9, 11.1%) had delayed bleeding. Among patients who underwent surgery, 5/11 (45.5%) were deemed overtreated and three had post-surgical complications.
Conclusions
We propose EVR as an alternative technique for giant polyp resection due to its safety, effectiveness, cost-efficiency, and the advantage of avoiding the need to postpone polypectomy to a later time. Further prospective studies might help improve this experience and enhance the technique.

Citations

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Development and validation of a predictive model for pathological upgrading in colorectal polyps based on endoscopic forceps biopsy
Ziyao Cheng, Chang Zhang, Feng Yu
Frontiers in Medicine.2026;[Epub] CrossRef
Large colorectal lesions: Expanding the boundaries of endoscopic management
Amit Bagrodia, Venkatesh Vaithiyam, Supraja Laguduva Mohan
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Endoscopic approaches for the management of giant colonic polyps
Yunho Jung
Clinical Endoscopy.2024; 57(4): 468. CrossRef

9,268 View
263 Download
3 Web of Science
3 Crossref

Systematic Review and Meta-Analysis

Outcomes of thin versus thick-wire snares for cold snare polypectomy: a systematic review and meta-analysis: Suprabhat Giri, Vaneet Jearth, Harish Darak, Sridhar Sundaram; Clin Endosc 2022;55(6):742-750. Published online November 9, 2022; DOI: https://doi.org/10.5946/ce.2022.141

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Cold snare polypectomy (CSP) is commonly used for the resection of colorectal polyps ≤10 mm. Data regarding the influence of snare type on CSP effectiveness are conflicting. Hence, this meta-analysis aimed to compare the outcomes and safety of thin- and thick-wire snares for CSP.
Methods
A comprehensive search of the literature published between 2000 and 2021 was performed of various databases for comparative studies evaluating the outcomes of thin- versus thick-wire snares for CSP.
Results
Five studies with data on 1,425 polyps were included in the analysis. The thick-wire snare was comparable to the thin-wire snare with respect to complete histological resection (risk ratio [RR], 1.03; 95% confidence interval [CI], 0.97–1.09), overall bleeding (RR, 0.98; 95% CI, 0.40–2.40), polyp retrieval (RR, 1.01; 95% CI, 0.97–1.04), and involvement of submucosa in the resection specimen (RR, 1.28; 95% CI, 0.72–2.28). There was no publication bias and a small study effect, and the relative effects remained the same in the sensitivity analysis.
Conclusions
CSP using a thin-wire snare has no additional benefit over thick-wire snares in small colorectal polyps. Factors other than snare design may play a role in improving CSP outcomes.

Citations

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High‐Performance Dedicated Snares with Tip Attachments can Overcome Current Disadvantages in Cold Snare Polypectomy
Ryohei Hirose, Naohisa Yoshida, Takuma Yoshida, Hiroki Mukai, Katsuma Yamauchi, Hajime Miyazaki, Naoto Watanabe, Risa Bandou, Ken Inoue, Osamu Dohi, Yoshikazu Inagaki, Yutaka Inada, Takaaki Murakami, Akio Yanagisawa, Hiroshi Ikegaya, Takaaki Nakaya, Yoshi
Advanced Materials Technologies.2025;[Epub] CrossRef
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Hye Kyung Jeon, Gwang Ha Kim
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Mechanisms of cutting soft tissues using snare-type tools
Jinghang Wang, Urara Satake, Toshiyuki Enomoto
Medical Engineering & Physics.2025; 138: 104314. CrossRef
Efficacy and safety of cold snare polypectomy for outpatient treatment of sessile polyps smaller than 10mm
Chunmei Li, Xinyu Xie, Jian Qin, Yufei Ding, Xiaojuan Ma, Shanshan Liu, Miao Chen, Dandan Dong, Jing Sun, Xuedan Deng, Lulu Liu, Hongyan Cui
BMC Gastroenterology.2025;[Epub] CrossRef
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Giulia Gibiino, Cecilia Binda, Matteo Secco, Lorenzo Cosentino, Francesco Poggioli, Stefania Cappetta, Davide Trama, Andrea Fabbri, Chiara Coluccio, Carlo Fabbri
Journal of Clinical Medicine.2025; 14(16): 5846. CrossRef
Factors determining the resection ability of snares in cold snare polypectomy: Construction of an ex vivo model for accurately evaluating resection ability
Ryohei Hirose, Takuma Yoshida, Naohisa Yoshida, Katsuma Yamauchi, Hajime Miyazaki, Naoto Watanabe, Risa Bandou, Ken Inoue, Hiroshi Ikegaya, Takaaki Nakaya, Yoshito Itoh
Digestive Endoscopy.2024; 36(5): 573. CrossRef
Effectiveness and safety of thin vs. thick cold snare polypectomy of small colorectal polyps: Systematic review and meta-analysis
Rishad Khan, Sunil Samnani, Marcus Vaska, Samir C Grover, Catharine M Walsh, Jeffrey Mosko, Michael J Bourke, Steven J Heitman, Nauzer Forbes
Endoscopy International Open.2024; 12(01): E99. CrossRef
International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
Clinical Endoscopy.2024; 57(2): 141. CrossRef
IDEN Consensus on Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
The Korean Journal of Gastroenterology.2024; 83(6): 217. CrossRef
International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
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Advances in Endoscopic Resection
Mitsuru Esaki, Sonmoon Mohapatra, Norio Fukami
Gastroenterology Clinics of North America.2024; 53(4): 709. CrossRef
Comparative meta-analysis of cold snare polypectomy and endoscopic mucosal resection for colorectal polyps: assessing efficacy and safety
Shouqi Wang, Qi Zhang, Li Rong Meng, Ying Wu, Pedro Fong, Weixia Zhou
PeerJ.2024; 12: e18757. CrossRef
Does the wire diameter really determine the outcomes in cold snare polypectomy?
S Giri, S Sundaram
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Cold resection for colorectal polyps: where we are and where we are going?
Antonio Capogreco, Ludovico Alfarone, Davide Massimi, Alessandro Repici
Expert Review of Gastroenterology & Hepatology.2023; 17(7): 719. CrossRef
Endoscopic treatment of colorectal polyps and early colorectal cancer
Yunho Jung
Journal of the Korean Medical Association.2023; 66(11): 642. CrossRef

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Reviews

Korean guidelines for postpolypectomy colonoscopic surveillance: 2022 revised edition: Su Young Kim, Min Seob Kwak, Soon Man Yoon, Yunho Jung, Jong Wook Kim, Sun-Jin Boo, Eun Hye Oh, Seong Ran Jeon, Seung-Joo Nam, Seon-Young Park, Soo-Kyung Park, Jaeyoung Chun, Dong Hoon Baek, Mi-Young Choi, Suyeon Park, Jeong-Sik Byeon, Hyung Kil Kim, Joo Young Cho, Moon Sung Lee, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy, Korean Society of Gastroenterology, Korean Association for the Study of Intestinal Diseases; Clin Endosc 2022;55(6):703-725. Published online October 13, 2022; DOI: https://doi.org/10.5946/ce.2022.136

Abstract PDF Supplementary Material PubReader ePub

Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for the management of advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: (1) adenoma ≥10 mm in size; (2) 3 to 5 (or more) adenomas; (3) tubulovillous or villous adenoma; (4) adenoma containing high-grade dysplasia; (5) traditional serrated adenoma; (6) sessile serrated lesion (SSL) containing any grade of dysplasia; (7) serrated polyp of at least 10 mm in size; and (8) 3 to 5 (or more) SSLs. More studies are needed to fully comprehend the patients most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

Citations

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Influence of Lifestyles on Polyp Burden and Cancer Development in Hereditary Colorectal Cancer Syndromes
Hye Kyung Hyun, Ji Soo Park, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
Journal of Gastroenterology and Hepatology.2025; 40(2): 433. CrossRef
Minimum Platelet Count Threshold for Safe Colonoscopic Polypectomy: A Large-Scale Propensity Scored-Matched Analysis
Hye Kyung Hyun, Nak-Hoon Son, Cheal Wung Huh, Hyun Chul Lim, So Hyeon Gwon, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
American Journal of Gastroenterology.2025; 120(12): 2918. CrossRef
Role of Artificial Intelligence in Improving Quality of Colonoscopy
Ji Hyun Kim, Sung Chul Park, Hyun-Soo Kim
The Korean Journal of Gastroenterology.2025; 85(2): 137. CrossRef
Prevalence and Characteristics of Colorectal Serrated Polyps
Soo-Young Na
Journal of Digestive Cancer Research.2025; 13(1): 47. CrossRef
Impact of Guideline-concordant Post-polypectomy Colonoscopy Surveillance on Colorectal Cancer Incidence and Mortality
Samir Gupta, Joshua Demb, Jiyue Qin, Ashley Earles, Mark Lamm, Chyke A. Doubeni, Maria Elena Martinez, Tonya R. Kaltenbach, Andrew J. Gawron, Shailja C. Shah, Karen Messer, Lin Liu
Clinical Gastroenterology and Hepatology.2025;[Epub] CrossRef
Association between Atherosclerosis and High-Risk Colorectal Adenomas based on Cardio-Ankle Vascular Index and Ankle-Brachial Index
Jung Ho Lee, Hyunseok Cho, Sang Hoon Lee, Sung Joon Lee, Chang Don Kang, Dae Hee Choi, Jin Myung Park, Seung-Joo Nam, Tae Suk Kim, Ji Hyun Kim, Sung Chul Park
The Korean Journal of Gastroenterology.2024; 83(4): 143. CrossRef
A survey of current practices in post-polypectomy surveillance in Korea
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoo
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Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 Revision
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Post-polypectomy surveillance: the present and the future: Masau Sekiguchi, Takahisa Matsuda, Kinichi Hotta, Yutaka Saito; Clin Endosc 2022;55(4):489-495. Published online July 11, 2022; DOI: https://doi.org/10.5946/ce.2022.097

Abstract PDF PubReader ePub

An appropriate post-polypectomy surveillance program requires the effectiveness of reducing colorectal cancer and safety. In addition, the post-polypectomy surveillance program should consider the burden of limited medical resource capacity, cost-effectiveness, and patient adherence. In this sense, a risk-stratified surveillance program based on baseline colonoscopy results is ideal. Major international guidelines for post-polypectomy surveillance, such as those from the European Union and the United States, have recommended risk-stratified surveillance programs. Both guidelines have recently been updated to better differentiate between high- and low-risk individuals. In both updated guidelines, more individuals have been downgraded to lower-risk groups that require less frequent or no surveillance. Furthermore, increased attention has been paid to the surveillance of patients who undergo serrated polyp removal. Previous guidelines in Japan did not clearly outline the risk stratification in post-polypectomy surveillance. However, the new colonoscopy screening and surveillance guidelines presented by the Japan Gastroenterological Endoscopy Society include a risk-stratified post-polypectomy surveillance program. Further discussion and analysis of unresolved issues in this field, such as the optimal follow-up after the first surveillance, the upper age limit for surveillance, and the ideal method for improving adherence to surveillance guidelines, are warranted.

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S. Redondo Evangelista, M. Sierra Morales, I. Bartolomé Oterino, P. García Centeno, A. Santos Rodríguez
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Metabolic‐associated fatty liver disease is associated with colorectal adenomas in young and older Korean adults
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Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
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Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
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9,111 View
336 Download
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Current Treatment Strategy for Superficial Nonampullary Duodenal Epithelial Tumors: Tetsuya Suwa, Kohei Takizawa, Noboru Kawata, Masao Yoshida, Yohei Yabuuchi, Yoichi Yamamoto, Hiroyuki Ono; Clin Endosc 2022;55(1):15-21. Published online September 29, 2021; DOI: https://doi.org/10.5946/ce.2021.141

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Endoscopic submucosal dissection (ESD) is the standard treatment method for esophageal, gastric, and colorectal cancers. However, it has not been standardized for duodenal lesions because of its high complication rates. Recently, minimally invasive and simple methods such as cold snare polypectomy and underwater endoscopic mucosal resection have been utilized more for superficial nonampullary duodenal epithelial tumors (SNADETs). Although the rate of complications associated with duodenal ESD has been gradually decreasing because of technical advancements, performing ESD for all SNADETs is unnecessary. As such, the appropriate treatment plan for SNADETs should be chosen according to the lesion type, patient condition, and endoscopist’s skill.

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Utility of underwater endoscopic mucosal resection combined with a protruding anchor by saline injection for superficial non-ampullary duodenal tumors: a retrospective study in Japan
Yoshie Nomoto, Satoshi Shinozaki, Yoshimasa Miura, Hiroyuki Osawa, Yuji Ino, Tomonori Yano, Nikolaos Lazaridis, Hironori Yamamoto
Clinical Endoscopy.2025; 58(4): 561. CrossRef
Management of Adverse Events Related to Endoscopic Resection for Superficial Non-Ampullary Duodenal Epithelial Tumors
Osamu Dohi, Tomoko Ochiai, Mayuko Seya, Katsuma Yamauchi, Naoto Iwai, Reo Kobayashi, Ryohei Hirose, Elsayed Ghoneem, Ken Inoue, Naohisa Yoshida
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Yu Zhang, Man-Li Cui, Ming-Xin Zhang, Chao Sun
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Reply to the comments on ‘Utility of underwater endoscopic mucosal resection combined with a protruding anchor by saline injection for superficial non-ampullary duodenal tumors: a retrospective study in Japan'
Hironori Yamamoto, Yoshie Nomoto, Satoshi Shinozaki, Yoshimasa Miura, Hiroyuki Osawa
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International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
Gut and Liver.2024; 18(5): 764. CrossRef
A method of “Noninjecting Resection using Bipolar Soft coagulation mode; NIRBS” for superficial non-ampullary duodenal epithelial tumor: a pilot study
Mitsuo Tokuhara, Yasushi Sano, Yoshifumi Watanabe, Hidetoshi Nakata, Hiroko Nakahira, Shingo Furukawa, Takuya Ohtsu, Naohiro Nakamura, Takashi Ito, Ikuko Torii, Takeshi Yamashina, Masaaki Shimatani, Makoto Naganuma
BMC Gastroenterology.2024;[Epub] CrossRef
Underwater Endoscopic Mucosal Resection Versus Conventional Endoscopic Mucosal Resection for Superficial Non-ampullary Duodenal Epithelial Tumors ≤20 mm
Zhikun Yin, Ji Li, Weilin Yang, Weifeng Huang, Dong Xu, Xiaoyi Lei, Jinyan Zhang
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Long-term outcomes of endoscopic resection for duodenal neuroendocrine tumors
Kiyoun Yi, Gwang Ha Kim, Su Jin Kim, Cheol Woong Choi, Moon Won Lee, Bong Eun Lee, Geun Am Song
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Endoscopic management of NADTs
Enrique Pérez-Cuadrado-Robles, Pierre H. Deprez
Endoscopy International Open.2022; 10(06): E733. CrossRef
Duodenaladenome und -karzinome: chirurgische Therapiekonzepte
Michael Ghadimi, Jochen Gaedcke
Allgemein- und Viszeralchirurgie up2date.2022; 16(03): 257. CrossRef
Issues and Prospects of Current Endoscopic Treatment Strategy for Superficial Non-Ampullary Duodenal Epithelial Tumors
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Case Report

Extracutaneous mastocytoma of colon: a case report and literature review: Min Su Chu, Eui Joong Kim; Clin Endosc 2022;55(6):810-814. Published online July 7, 2021; DOI: https://doi.org/10.5946/ce.2021.003

Abstract PDF PubReader ePub

Extracutaneous mastocytoma is a rare benign tumor composed of mature mast cells and is located in tissues other than the skin. We report the case of a 61-year-old male who was diagnosed with extracutaneous mastocytoma via colonoscopic polypectomy and biopsy. To our knowledge, this was the first case of a solitary extracutaneous mastocytoma of the colon. We reported this case and reviewed the literature.

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Incidental discovery of KIT‐mutated mastocytoma in a colon polyp
Naseema Gangat, Ellen McPhail, Kaaren Reichard, Attilio Orazi, Animesh Pardanani, Ayalew Tefferi
American Journal of Hematology.2024; 99(5): 973. CrossRef

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Original Articles

Is Submucosal Injection Helpful in Cold Snare Polypectomy for Small Colorectal Polyps?: Ji Hyun Song, Shai Friedland; Clin Endosc 2021;54(3):397-403. Published online February 9, 2021; DOI: https://doi.org/10.5946/ce.2020.226

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Background
/Aims: Cold snare polypectomy (CSP) is an effective method of polyp removal for small colorectal polyps. However, the effect of submucosal injection in cold snare endoscopic mucosal resection (CS-EMR) for small polyps is unclear. Therefore, this study aimed to evaluate the effect of submucosal injection in CS-EMR for small polyps.
Methods
Between 2018 and 2019, 100 consecutive small colorectal polyps (5–10 mm) were identified in 58 patients. The first 50 consecutive polyps were removed by CS-EMR, and the remaining 50 were removed by CSP. Demographic data, clinical data, endoscopic findings, procedure times, complication rates, and pathology data were collected.
Results
No difference in the complete resection rate was observed between the CS-EMR and CSP groups. A total of 9 polyps showed post-polypectomy bleeding (7 had immediate bleeding, 1 had delayed bleeding, and 1 had both immediate and delayed bleeding). No difference in the bleeding rate was observed between the two groups. In multivariate analysis, warfarin (odds ratio [OR], 42.334; 95% confidence interval [CI], 1.006–1,781.758) and direct-acting oral anticoagulants (OR, 35.244; 95% CI, 3.853–322.397) showed a significantly increased risk of bleeding.
Conclusions
The effect of submucosal injection in CSP was not significant for small colorectal polyps.

Citations

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Survey of the Actual Practices Used for Endoscopic Removal of Colon Polyps in Korea: A Comparison with the Current Guidelines
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong-Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoon Yang, Eun R
Gut and Liver.2025; 19(1): 77. CrossRef
Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial
Ramona Schiumerini, Paola Baccarini, Adele Fornelli, Davide Allegri, Francesca Lodato, Alessia Gazzola, Pasquale Apolito, Nunzio P. Longo, Anna M. Polifemo, Franca Patrizi, Federica Buonfiglioli, Stefania Ghersi, Marco Bassi, Liza Ceroni, Antonella Ghetti
Clinical Endoscopy.2025; 58(2): 291. CrossRef
Cold sub-mucosal injection versus traditional cold snare polypectomy for diminutive and small colorectal polyps: A systematic review and meta-analysis
Yong-Cai Lv, Quan Dong, Yan-Hua Yao, Jing-Jing Lei
Indian Journal of Gastroenterology.2024; 43(6): 1111. CrossRef
Colorectal cold snare polypectomy: Current standard technique and future perspectives
Fumiaki Ishibashi, Sho Suzuki, Mizuki Nagai, Kentaro Mochida, Tetsuo Morishita
Digestive Endoscopy.2023; 35(3): 278. CrossRef
The efficacy and safety of cold snare polypectomy with submucosal injection for the removal of polyps less than 20 mm in size: a systematic review and meta‐analysis
Zheng Liang, Yongqiu Wei, Shutian Zhang, Peng Li
Journal of Gastroenterology and Hepatology.2023; 38(11): 1892. CrossRef
Impact of Submucosal Saline Injection During Cold Snare Polypectomy for Colorectal Polyps Sized 3–9 mm: A Multicenter Randomized Controlled Trial
Yi Mou, Liansong Ye, Xiaobo Qin, Rui Feng, Lifan Zhang, Qin Hu, Tingting Cao, Xinyue Zhou, Wu Wen, Chuanming Zhang, Zonghua Chen, Yi Liu, Zhimin Yang, Tao Huo, Fang Pan, Xuelian Li, Bing Hu
American Journal of Gastroenterology.2023; 118(10): 1848. CrossRef
Cold resection for colorectal polyps: where we are and where we are going?
Antonio Capogreco, Ludovico Alfarone, Davide Massimi, Alessandro Repici
Expert Review of Gastroenterology & Hepatology.2023; 17(7): 719. CrossRef
Cold snare endoscopic mucosal resection for colon polyps: a systematic review and meta-analysis
Mohamed Abdallah, Khalid Ahmed, Daniyal Abbas, Mouhand F. H. Mohamed, Gaurav Suryawanshi, Nicholas McDonald, Natalie Wilson, Shifa Umar, Aasma Shaukat, Mohammad Bilal
Endoscopy.2023; 55(12): 1083. CrossRef
Endoscopic treatment of colorectal polyps and early colorectal cancer
Yunho Jung
Journal of the Korean Medical Association.2023; 66(11): 642. CrossRef

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Dedicated Cold Snare vs. Traditional Snare for Polypectomy of Diminutive and Small Lesions in a Porcine Model: A Research Group for Endoscopic Instruments and Stents (REIS) Study: Han Hee Lee, Bo-In Lee, Jung-Wook Kim, Hyun Lim, Si Hyung Lee, Jun-Hyung Cho, Yunho Jung, Kyoung Oh Kim, Chan Gyoo Kim, Kee Myung Lee, Jong-Jae Park, Myung-Gyu Choi, Hoon Jai Chun, Ho Gak Kim; Clin Endosc 2021;54(3):390-396. Published online September 10, 2020; DOI: https://doi.org/10.5946/ce.2020.096

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: The aim of this in vivo animal study was to evaluate the effectiveness and safety of dedicated cold snare (DCS) compared with those of traditional snare (TS) for cold snare polypectomy (CSP).
Methods
A total of 36 diminutive (5 mm) and 36 small (9 mm) pseudolesions were made by electrocoagulation in the colons of mini-pigs.
Results
For the diminutive lesions, there were no significant differences in technical success rate, procedure time, or complete resection rate between the DCS and TS groups; the rate of uneven resection margin in the DCS group was significantly lower than that of the TS group. For small lesions, technical success rate and complete resection rate were significantly higher in the DCS group than in the TS group (100% [18/18] vs. 55.6% [10/18], p=0.003; 94.4% [17/18] vs. 40% [4/10], p=0.006). In addition, the procedure duration was significantly shorter, and the rate of uneven resection margin was significantly lower in the DCS group (28.5 sec vs. 66.0 sec, p=0.006; 11.1% [2/18] vs. 100% [10/10], p<0.001). Two cases of perforation occurred in the DCS group. Multivariate analysis revealed that DCS use was independently associated with complete resection.
Conclusions
DCS is superior to TS in terms of technical success, complete resection, and reducing the duration of the procedure for CSP of small polyps.

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Comparison of complete resection rates in cold snare polypectomy using two different wire diameter snares: A randomized controlled study
Toshiki Horii, Sho Suzuki, Akihiro Sugita, Misa Yamauchi, Hisatomo Ikehara, Chika Kusano, Takuji Gotoda
Journal of Gastroenterology and Hepatology.2023; 38(5): 752. CrossRef
Comparison of the clinical efficacy of cold snare polypectomy using a thin-wire snare and thick-wire snare for small colorectal polyps
Hong Jin Yoon, Yunho Jung, Young Sin Cho, Il-Kwun Chung
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Big Issues on Small Polyps: An Ideal Device, But Is It for an Ideal Indication?
Yoji Takeuchi
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Cold versus hot polypectomy/endoscopic mucosal resection–A review of current evidence
Raquel Ortigão, Jochen Weigt, Ahmed Afifi, Diogo Libânio
United European Gastroenterology Journal.2021; 9(8): 938. CrossRef

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Review

Endoscopic Management of Post-Polypectomy Bleeding: Aditya Gutta, Mark A. Gromski; Clin Endosc 2020;53(3):302-310. Published online September 17, 2019; DOI: https://doi.org/10.5946/ce.2019.062

Abstract PDF PubReader ePub

Post-polypectomy bleeding (PPB) is one of the most common complications of endoscopic polypectomy. There are multiple risk factors related to patient and polyp characteristics that should be considered. In most cases, immediate PPB can be effectively managed endoscopically when recognized and managed promptly. Delayed PPB can manifest in a myriad of ways. In severe delayed PPB, resuscitation for hemodynamic stabilization should be prioritized, followed by endoscopic evaluation and therapy once the patient is stabilized. Future areas of research in PPB include the risks of direct oral anticoagulants and of specific electrosurgical settings for hot-snare polypectomy vs. cold-snare polypectomy, benefits of closure of post-polypectomy mucosal defects using through-the-scope clips, and prospective comparative evaluation of newer hemostasis agents such as hemostatic spray powder and over-the-scope clips.

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Case Report

First Characterization with Ultrasound Contrast Agent of a Fibrovascular Polyp Before Its Endoscopic Resection: A Case Report (with Videos): Nicolas Williet, Radwan Kassir, Francois Casteillo, Violaine Yvorel, Cyril Habougit, Xavier Roblin, Jean-Marc Phelip; Clin Endosc 2019;52(2):186-190. Published online October 5, 2018; DOI: https://doi.org/10.5946/ce.2018.083

Abstract PDF Supplementary Material PubReader ePub

We described for the first time the contrast enhancement of a giant fibrovascular esophageal polyp using ultrasound contrast agent, Sonovue® (Bracco, Milan, Italy) during echoendoscopy. Fine Doppler was unsuccessful in showing vascularization due to the mobile characteristic of the tumor. In contrast, via Sonovue® , tissue microcirculation was highlighted inside the entire head of the polyp, leading to better appreciate the risk of bleeding related to its resection. In a second part, we showed the feasibility of classic polypectomy for this giant polyp (5×5 cm) without complication and results of control endoscopy at 3 months. The present case is summarized in a video.

Citations

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Hybrid laparo-endoscopic access: New approach to surgical treatment for giant fibrovascular polyp of esophagus: A case report and review of literature
Seda Dzhantukhanova, Lyudmila Grigori Avetisyan, Amina Badakhova, Yury Starkov, Andrey Glotov
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Pirogov Russian Journal of Surgery.2023; (11): 123. CrossRef

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Original Article

Colonic Postpolypectomy Bleeding Is Related to Polyp Size and Heparin Use: Flavia Pigò, Helga Bertani, Mauro Manno, Vincenzo Giorgio Mirante, Angelo Caruso, Santi Mangiafico, Raffaele Manta, Anna Maria Rebecchi, Rita Luisa Conigliaro; Clin Endosc 2017;50(3):287-292. Published online February 9, 2017; DOI: https://doi.org/10.5946/ce.2016.126

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Background
/Aims: We studied factors influencing colon postpolypectomy bleeding (PPB), with a focus on antithrombotic and anticoagulation therapy.
Methods
We conducted a retrospective case-control study of all patients who underwent polypectomy at our tertiary referral center in Italy between 2007 and 2014. Polyp characteristics (number of polyps removed per patient, size, morphology, location, resection technique, prophylactic hemostasis methods) and patient characteristics (age, sex, comorbidities, medication) were analyzed.
Results
The case and control groups included 118 and 539 patients, respectively. The two groups differed in the frequency of comorbidities (69% vs. 40%, p=0.001), polyps removed (27% vs. 18%, p=0.02), and use of heparin therapy (23% vs. 1%, p<0.001). A total of 279 polyps in the case group and 966 in the control group were nonpedunculated (69% vs. 81%, p=0.01) and measured ≥10 mm (78% vs. 32%, p=0.001). Multivariate analysis showed that polyps ≥10 mm (odds ratio [OR], 6.1; 95% confidence interval [CI], 2.3–15.5), administration of heparin (OR, 16.5; 95% CI, 6.2–44), comorbidity (OR, 2.3; 95% CI, 1.4–3.9), and presence of ≥2 risk factors (OR, 3.2; 95% CI, 1.7–6.0) were associated with PPB.
Conclusions
The incidence of PPB increases with polyp size ≥10 mm, heparin use, comorbidity, and presence of ≥2 risk factors.

Citations

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Safety of cold snare resection techniques for removal of polyps in the small colon in patients taking clopidogrel and aspirin: a Korean Association for the Study of Intestinal Diseases prospective multicenter study
Tae-Geun Gweon, Hyun Gun Kim, Yunho Jung, Seong Ran Jeon, Soo-Young Na, Yoo Jin Lee, Tae Ho Kim
Gastrointestinal Endoscopy.2025; 101(4): 866. CrossRef
Delphi consensus statement for the management of delayed post-polypectomy bleeding
Enrique Rodríguez de Santiago, Sandra Pérez de la Iglesia, Diego de Frutos, José Carlos Marín-Gabriel, Carolina Mangas-SanJuan, Raúl Honrubia López, Hugo Uchima, Marta Aicart-Ramos, Miguel Ángel Rodríguez Gandía, Eduardo Valdivielso Cortázar, Felipe Ramos
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
Risk factors for post-polypectomy bleeding in patients with end-stage renal disease undergoing colonoscopic polypectomy
Jung Hyun Ji, Hyun Woo Kim, Jihye Park, Soo Jung Park, Jae Hee Cheon, Tae Il Kim, Jae Jun Park
Surgical Endoscopy.2024; 38(2): 846. CrossRef
Polypectomy for Diminutive and Small Colorectal Polyps
Melissa Zarandi-Nowroozi, Roupen Djinbachian, Daniel von Renteln
Gastrointestinal Endoscopy Clinics of North America.2022; 32(2): 241. CrossRef
Effects of antithrombotic agents on post-operative bleeding after endoscopic resection of gastrointestinal neoplasms and polyps: A systematic review and meta-analysis
Bing-Jie Xiang, Yu-Hong Huang, Min Jiang, Cong Dai
World Journal of Meta-Analysis.2020; 8(5): 410. CrossRef
Effects of antithrombotic agents on post-operative bleeding after endoscopic resection of gastrointestinal neoplasms and polyps: A systematic review and meta-analysis
Bing-Jie Xiang, Yu-Hong Huang, Min Jiang, Cong Dai
World Journal of Meta-Analysis.2020; 8(5): 411. CrossRef
Post-polypectomy Visible Vessel
Matthew Woo, Robert Bechara
Journal of the Canadian Association of Gastroenterology.2018; 1(2): 51. CrossRef
Colorectal cancer screening program using FIT: quality of colonoscopy varies according to hospital type
Isabel Portillo, Isabel Idigoras, Isabel Bilbao, Eunate Arana-Arri, María José Fernández-Landa, Jose Luis Hurtado, Cristina Sarasaqueta, Luis Bujanda
Endoscopy International Open.2018; 06(09): E1149. CrossRef
Prediction and Prevention of Postpolypectomy Bleeding: Necessity of a Different Approach for Patients Using Antithrombotic Agents
Duk Hwan Kim
Clinical Endoscopy.2017; 50(3): 217. CrossRef

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Reviews

Optimal Colonoscopy Surveillance Interval after Polypectomy: Tae Oh Kim; Clin Endosc 2016;49(4):359-363. Published online July 29, 2016; DOI: https://doi.org/10.5946/ce.2016.080

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The detection and removal of adenomatous polyps and postpolypectomy surveillance are considered important for the control of colorectal cancer (CRC). Surveillance using colonoscopy is an effective tool for preventing CRC after colorectal polypectomy, especially if compliance is good. In current practice, the intervals between colonoscopies after polypectomy are variable. Different recommendations for recognizing at risk groups and defining surveillance intervals after an initial finding of colorectal adenomas have been published. However, high-grade dysplasia and the number and size of adenomas are known major cancer predictors. Based on this, a subgroup of patients that may benefit from intensive surveillance colonoscopy can be identified.

Citations

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Gender disparities in colorectal polyps
A. K. Safiyeva
Klinicheskaia khirurgiia.2021; 88(1-2): 57. CrossRef
Three-year colonoscopy surveillance after polypectomy in Korea: a Korean Association for the Study of Intestinal Diseases (KASID) multicenter prospective study
Won Seok Choi, Dong Soo Han, Chang Soo Eun, Dong Il Park, Jeong-Sik Byeon, Dong-Hoon Yang, Sung-Ae Jung, Sang Kil Lee, Sung Pil Hong, Cheol Hee Park, Suck-Ho Lee, Jeong-Seon Ji, Sung Jae Shin, Bora Keum, Hyun Soo Kim, Jung Hye Choi, Sin-Ho Jung
Intestinal Research.2018; 16(1): 126. CrossRef

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2 Crossref

Endoscopic Instruments and Electrosurgical Unit for Colonoscopic Polypectomy: Hong Jun Park; Clin Endosc 2016;49(4):350-354. Published online July 11, 2016; DOI: https://doi.org/10.5946/ce.2016.059

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Colorectal polypectomy is an effective method for prevention of colorectal cancer. Many endoscopic instruments have been used for colorectal polypectomy, such as snares, forceps, endoscopic clips, a Coagrasper, retrieval net, injector, and electrosurgery generator unit (ESU). Understanding the characteristics of endoscopic instruments and their proper use according to morphology and size of the colorectal polyp will enable endoscopists to perform effective polypectomy. I reviewed the characteristics of endoscopic instruments for colorectal polypectomy and their appropriate use, as well as the basic principles and settings of the ESU.

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Expert consensus on the clinical application of high‐frequency electrosurgery in digestive endoscopy (2020, Shanghai)
Yu Bai, Fan Yang, Cui Liu, De Feng Li, Shi Wang, Rong Lin, Zhen Ding, Wen Bo Meng, Zhao Shen Li, En Qiang Linghu
Journal of Digestive Diseases.2022; 23(1): 2. CrossRef
Thermic Epidermic Tissue Surgical Generator Using Bipolar Electrode
Dhanalakshmi K.S, Azhagu Jaisudhan Pazhani A, Anusha Padmavathy R
Innovations in Information and Communication Technology Series.2021; : 68. CrossRef

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Original Articles

Use of a Double-Channel Gastroscope Reduces Procedural Time in Large Left-Sided Colonic Endoscopic Mucosal Resections: Evangelos Voudoukis, Georgios Tribonias, Aikaterini Tavernaraki, Angeliki Theodoropoulou, Emmanouil Vardas, Konstantina Paraskeva, Gregorios Chlouverakis, Gregorios A. Paspatis; Clin Endosc 2015;48(2):136-141. Published online March 27, 2015; DOI: https://doi.org/10.5946/ce.2015.48.2.136

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Background/Aims

Endoscopic mucosal resection (EMR) of large colorectal lesions is associated with increased procedural time. The objective of this study was to evaluate the effect of double-channel gastroscope (DCG) use on the procedural time of EMRs in the rectosigmoid area.

Methods

All EMRs for sessile or flat rectosigmoid lesions ≥2 cm performed between July 2011 and September 2012 were retrospectively analyzed.

Results

There were 55 lesions ≥2 cm in the rectosigmoid area in 55 patients, of which 26 were removed by EMR using a DCG (DC group) and 29 by using an ordinary colonoscope or gastroscope (OS group). The mean size of the removed polyps, morphology, adverse effects, and other parameters were similar between the two groups. The mean procedural time was significantly lower in the DC group than in the OS group (24.4±18.3 minutes vs. 36.3±24.4 minutes, p=0.015). Moreover, in a subgroup of patients with polyps >40 mm, the statistical difference in the mean procedural time between the DC and OS groups was even more pronounced (33±21 minutes vs. 58.7±20.6 minutes, p=0.004).

Conclusions

Our data suggest that the use of a DCG in the resection of large nonpedunculated rectosigmoid lesions significantly reduces the procedural time.

Citations

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Dual Channel Endoscopic Mucosal Resection
Julia T. Saraidaridis, Racquel S. Gaetani, Peter W. Marcello
Clinics in Colon and Rectal Surgery.2024; 37(05): 295. CrossRef
Endoscopic management of difficult laterally spreading tumors in colorectum
Edgar Castillo-Regalado, Hugo Uchima
World Journal of Gastrointestinal Endoscopy.2022; 14(3): 113. CrossRef
Novel technique for endoscopic en bloc resection (EMR+) – Evaluation in a porcine model
Benjamin Meier, Andreas Wannhoff, Christoph Klinger, Karel Caca
World Journal of Gastroenterology.2019; 25(28): 3764. CrossRef
Endoscopic mucosal resection and endoscopic submucosal dissection for colorectal lesions: A systematic review
Antonella De Ceglie, Cesare Hassan, Benedetto Mangiavillano, Takahisa Matsuda, Yutaka Saito, Lorenzo Ridola, Pradeep Bhandari, Federica Boeri, Massimo Conio
Critical Reviews in Oncology/Hematology.2016; 104: 138. CrossRef
Is the Double Channel Gastroscope Useful in Endoscopic Mucosal Resection for Large Sessile Colon Polyps?
Kwang An Kwon
Clinical Endoscopy.2015; 48(2): 89. CrossRef

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Postpolypectomy Fever, a Rare Adverse Event of Polypectomy: Nested Case-Control Study: Seung-Hoon Lee, Kyung-Jo Kim, Dong-Hoon Yang, Kee Wook Jeong, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Clin Endosc 2014;47(3):236-241. Published online May 31, 2014; DOI: https://doi.org/10.5946/ce.2014.47.3.236

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Background/Aims

Although postpolypectomy fever (PPF) without colon perforation or hemorrhage is rare, its incidence and risk factors have not been investigated. The objective of this study was to analyze the incidence and risk factors for PPF among inpatients.

Methods

Seven patients with PPF were matched with 70 patients without PPF from a total of 3,444 patients who underwent colonoscopic polypectomy. The PPF incidence during index hospitalization after colonoscopy was calculated, and univariate and multivariate analyses were performed to calculate the adjusted odds ratios (ORs) for risk factors.

Results

PPF without bleeding or perforation in the colon occurred in seven patients (0.2%). The median age was 58 years for cases and 61 years for controls. The median interval from polypectomy to occurrence of fever was 7 hours, and the median duration of fever was 9 hours. Polyp size >2 cm (adjusted OR, 1.08; 95% confidence interval [CI], 1.01 to 1.15; p=0.02) and hypertension (adjusted OR, 14.40; 95% CI, 1.23 to 180.87; p=0.03) were associated with a significantly increased risk of PPF. PPF increased the length of hospitalization.

Conclusions

Although the crude incidence of PPF is low, PPF may prolong hospitalization. Risk factors for PPF include hypertension and large polyps.

Citations

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A Case of Post-polypectomy Syndrome Following Endoscopic Resection of a Rectal Polyp
Faheem Anjum, Ayesha Muneer, Muhammad Usman, Arslan Arshad
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Comparison of three electrosurgical modes for endoscopic mucosal resection of 10- to 20-mm colorectal polyps: Randomized controlled trial
Su Luo, Feng Xiong, Sheng-gang Zhan, Zhenglei Xu, Ding-guo Zhang, Ting-ting Liu, Ying-xue Li, Cheng Wei, Ben-hua Wu, Yi-teng Meng, Rui-yue Shi, Jun Yao, Li-sheng Wang, De-feng Li
Endoscopy International Open.2025;[Epub] CrossRef
Cold Endoscopic Mucosal Resection (c-EMR) of Nonpedunculated Colorectal Polyps ≥20 mm
Daryl Ramai, Benjamin Clement, Marcello Maida, Melissa Previtera, Olivia W. Brooks, Yichen Wang, Saurabh Chandan, Banreet Dhindsa, Smit Deliwala, Antonio Facciorusso, Mouen Khashab, Andrew Ofosu
Journal of Clinical Gastroenterology.2024; 58(7): 661. CrossRef
Cold Snare Cut Versus Avulsion for Colonic Mucosal Resection: A Randomized Ex Vivo Porcine Study (the CONVINCE Study)
Neal A. Mehta, James K. Stone, Roberto Trasolini, Yuho Ono, Mandeep S. Sawhney
Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(4): 315. CrossRef
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Oral Science International.2022; 19(2): 79. CrossRef
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Wang Jing, Li Qinghua, Yang Zhiwen
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Pylephlebitis after sigmoid colonic polypectomy
Yuna Saito, Toshinori Nishizawa, Hiroko Arioka
BMJ Case Reports.2022; 15(12): e253095. CrossRef
Management of Pediatric Postendoscopy Fever
Julia M. Boster, Melissa Iwanowski, Robert E. Kramer
Journal of Pediatric Gastroenterology and Nutrition.2021; 72(2): 250. CrossRef
Cold versus hot polypectomy/endoscopic mucosal resection–A review of current evidence
Raquel Ortigão, Jochen Weigt, Ahmed Afifi, Diogo Libânio
United European Gastroenterology Journal.2021; 9(8): 938. CrossRef
Periprocedural adverse events after endoscopic resection of T1 colorectal carcinomas
Steffi E.M. van de Ven, Yara Backes, Mirrian Hilbink, Tom C.J. Seerden, Koen Kessels, Wouter H. de Vos tot Nederveen Cappel, John N. Groen, Frank H.J. Wolfhagen, Joost M.J. Geesing, Frank ter Borg, Jeroen van Bergeijk, B.W.M. Spanier, Marco W. Mundt, H.J.
Gastrointestinal Endoscopy.2020; 91(1): 142. CrossRef
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María Luisa García-García, Miguel Ángel Jiménez-Ballester, Enrique Girela-Baena, José Luis Aguayo-Albasini
Gastroenterología y Hepatología.2017; 40(7): 463. CrossRef
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Vicente Lorenzo‐Zúñiga, Jaume Boix, Vicente Moreno de Vega, Ignacio Bon, Ingrid Marín, Ramón Bartolí
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What Is Different between Postpolypectomy Fever and Postpolypectomy Coagulation Syndrome?
Hyung Wook Kim
Clinical Endoscopy.2014; 47(3): 205. CrossRef

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Case Report

A Polypoid Mucosa-Associated Lymphoid Tissue Lymphoma of the Stomach Treated with Endoscopic Polypectomy: Shin Young Min, Jun Haeng Lee, Poong-Lyul Rhee; Clin Endosc 2013;46(6):647-650. Published online November 19, 2013; DOI: https://doi.org/10.5946/ce.2013.46.6.647

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Mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach is the most common extranodal lymphoma of the gastrointestinal tract. It is usually accompanied by Helicobacter pylori infection, and eradication of H. pylori remains the mainstay of treatment for gastric MALT lymphoma. However, there is no consensus on the second-line treatment for patients with gastric MALT lymphoma who do not improve after successful H. pylori eradication. Here, we report the case of a 34-year-old woman who presented with a polypoid type of gastric MALT lymphoma on the greater curvature side of the upper body. Despite successful H. pylori eradication, the tumor did not regress after 6 months. Because the tumor had a semipedunculated polypoid morphology, gastric polypectomy was implemented as a second-line treatment. No recurrence occurred during the 3-year follow-up period. We suggest that gastric polypectomy be considered an alternative treatment modality for polypoid gastric MALT lymphoma that is unresponsive to H. pylori eradication.

Citations

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A polypoid mucosa-associated lymphoid tissue lymphoma causing gastric outlet obstruction: A case report and literature review
Chakib Khoury, Rebal Nahas, Karam Karam, Emanuel-Youssef Dib, Elias Fiani
Medical Reports.2025; 13: 100313. CrossRef

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Focused Review Series: Optical Diagnosis and New Management Strategy of Colorectal Polyps

New Paradigms for Colonoscopic Management of Diminutive Colorectal Polyps: Predict, Resect, and Discard or Do Not Resect?: Cesare Hassan, Alessandro Repici, Angelo Zullo, Prateek Sharma; Clin Endosc 2013;46(2):130-137. Published online March 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.2.130

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The possibility to predict in vivo the histology of colorectal polyps by advanced endoscopic imaging has resulted in the implementation of a more conservative management for diminutive lesions detected at colonoscopy. In detail, a predict-and-do-not-resect strategy has been proposed for diminutive lesions located in the rectosigmoid tract, whilst a predict-resect-and-discard policy has been advocated for nonrectosigmoid diminutive polyps. Recently, the American Society for Gastrointestinal Endoscopy set required thresholds to be met, before allowing the adoption of these policies in the clinical field. The ability of current endoscopic imaging in reaching these thresholds would depend on a complex interaction among the accuracy of advanced endoscopic imaging in differentiating between adenomatous and hyperplastic lesions, the prevalence of (advanced) neoplasia within diminutive lesions, and the type of surveillance intervals recommended. Aim of this review is to summarize the data supporting the application of both a predict-and-do-not-resect and a predict-resect-and-discard policies, also addressing the potential pitfalls associated with these strategies.

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Emeka Ray-Offor, Fatimah Biade Abdulkareem, Nze J Jebbin
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Diminutif ve Küçük Kolorektal Poliplerde Kanser Riskinin Değerlendirilmesi
Nurhan DEMİR
Artuklu International Journal of Health Sciences.2022; 2(3): 20. CrossRef
POLYP AND ADENOMA DETECTION RATE AND EVALUATION OF DIFFERENT POLYP RETRIEVAL METHODS IN PATIENTS UNDERGOING COLONOSCOPY IN KURDISTAN CENTER FOR GASTROENTEROLOGY AND HEPATOLOGY/SULAIMANI CITY (KCGH)
Sarkawt Ameen, Muhsin Mohammed, Mohammed Alshaikhani, Mohammed Mohammed, Taha Al-Karbuly, Dana Gharib, Araz Latif
JOURNAL OF SULAIMANI MEDICAL COLLEGE.2021; 11(4): 407. CrossRef
Efficacy and safety of cold versus hot snare polypectomy for resecting small colorectal polyps: Systematic review and meta‐analysis
Satoshi Shinozaki, Yasutoshi Kobayashi, Yoshikazu Hayashi, Hirotsugu Sakamoto, Alan Kawarai Lefor, Hironori Yamamoto
Digestive Endoscopy.2018; 30(5): 592. CrossRef
Clinical, endoscopic and pathological characteristics of colorectal polyps in elderly patients: Single-center experience
Lei Zhou, Heng Zhang, Shengbin Sun, Manling Huang, Jing Liu, Dan Xu, Min Song, Chenming Sun, Hui Li, Dan Zheng, Yan Fan, Yusheng Liao, Ping Wang, Jie Wu
Molecular and Clinical Oncology.2017; 7(1): 81. CrossRef
Results of total colonoscopy in the diagnosis of polyps. Case studies in Villavicencio, Colombia
Mauricio Alberto Melo-Peñaloza
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Narrow-band Imaging International Colorectal Endoscopic Classification to predict polyp histology: REDEFINE study (with videos)
Alessandro Repici, Camilla Ciscato, Loredana Correale, Raf Bisschops, Pradeep Bhandari, Evelien Dekker, Oliver Pech, Franco Radaelli, Cesare Hassan
Gastrointestinal Endoscopy.2016; 84(3): 479. CrossRef
The Assessment of the Colo-rectal Polyps in Order to the New Diagnostic and Therapeutic Strategies
Diac Andreea Raluca, Brusnic Olga, Gabos Gabriella, Onisor Danusia, Drasoveanu Silvia Cosmina, Boeriu Alina, Dobru Daniela Ecaterina
Acta Medica Marisiensis.2015; 61(3): 161. CrossRef
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Carlos Fernandes, Rolando Pinho, Iolanda Ribeiro, Joana Silva, Ana Ponte, João Carvalho
United European Gastroenterology Journal.2015; 3(4): 387. CrossRef
Accuracy of visual prediction of pathology of colorectal polyps: how accurate are we?
Prashant Sharma, John Frye, Frank Frizelle
ANZ Journal of Surgery.2014; 84(5): 365. CrossRef

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10 Crossref

Original Articles

Endoscopic Resection for Rectal Carcinoid Tumors: Comparision of Polypectomy and Endoscopic Submucosal Resection with Band Ligation: Sang Heon Lee, Seun Ja Park, Hyung Hun Kim, Kyung Sun Ok, Ji Hyun Kim, Sam Ryong Jee, Sang Young Seol, Bo Mi Kim; Clin Endosc 2012;45(1):89-94. Published online March 31, 2012; DOI: https://doi.org/10.5946/ce.2012.45.1.89; Retraction in: Clin Endosc 2015;48(1):87

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Clipping for the Prevention of Immediate Bleeding after Polypectomy of Pedunculated Polyps: A Pilot Study: Sun-Jin Boo, Jeong-Sik Byeon, Seon Young Park, Jong Sun Rew, Da Mi Lee, Sung Jae Shin, Dong Uk Kim, Geum Am Song; Clin Endosc 2012;45(1):84-88. Published online March 31, 2012; DOI: https://doi.org/10.5946/ce.2012.45.1.84

Abstract PDF PubReader ePub

Background/Aims

Immediate postpolypectomy bleeding (IPPB) increases the procedure time and it may disturb performing a safe polypectomy. The purpose of this study is to investigate whether clipping before snare polypectomy of large pedunculated polyps is useful for the prevention of IPPB.

Methods

This is a single arm, pilot study. We enrolled patients with pedunculated colorectal polyps that were 1 cm in size or more from 4 university hospitals between June 2009 and June 2010. Clips were applied at the stalk and snare polypectomy was then performed. The complications, including IPPB, were investigated.

Results

Fifty six pedunculated polyps in 47 patients (Male:Female=36:11; age, 56±11 years) were included. The size of the polyp heads was 17±8 mm. Tubular adenoma was most common (57%). The number of clips used before snare polypectomy was 2±0.5. The procedure was successful in all cases. IPPB occurred in 2 cases (3.6%), and both of these were managed by additional clipping. Delayed bleeding occurred in another one case (1.8%), which improved with conservative treatment. No perforation occurred.

Conclusions

We suggest that clipping before snare polypectomy of pedunculated polyps may be an easy and effective technique for the prevention of IPPB, and this should be confirmed in large scale, prospective, controlled studies.

Citations

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Cold snare polypectomy versus hot snare polypectomy for small pedunculated polyps: a cost-effectiveness analysis
Sneh Sonaiya, Raj Patel, Dushyant Singh Dahiya, Shahryar Khan, Charmy Parikh, Mark Stasiewicz, Pranav D. Patel, Kyaw Min Tun, Bradley Confer, Harshit S. Khara, Sumant Inamdar, Vignan Manne, Babu P. Mohan, Douglas G. Adler
Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Cold Versus Hot Endoscopic Mucosal Resection for ≥15 mm Large Nonpedunculated Colorectal Polyps
Sneh Sonaiya, Dushyant S. Dahiya, Raj Patel, Shahryar Khan, Charmy Parikh, Karan Yagnik, Chun-Han Lo, Kyaw Min Tun, Pranav D. Patel, Bradley Confer, Harshit S. Khara, Sumant Inamdar, Babu P. Mohan
Journal of Clinical Gastroenterology.2025;[Epub] CrossRef
A novel technique using endoscopic band ligation for removal of long-stalked (>10 mm) pedunculated colon polyps
Hyun Ho Choi, Chang Whan Kim, Hyung-Keun Kim, Sang Woo Kim, Sok Won Han, Kyung Jin Seo, Hiun-Suk Chae
Saudi Journal of Gastroenterology.2021; 27(5): 296. CrossRef
Endoscopic polypectomy devices
Vinay Chandrasekhara, Nikhil A. Kumta, Barham K. Abu Dayyeh, Manoop S. Bhutani, Pichamol Jirapinyo, Kumar Krishnan, John T. Maple, Joshua Melson, Rahul Pannala, Mansour A. Parsi, Amrita Sethi, Guru Trikudanathan, Arvind J. Trindade, David R. Lichtenstein
VideoGIE.2021; 6(7): 283. CrossRef
Prophylactic clip application for large pedunculated polyps before snare polypectomy may decrease immediate postpolypectomy bleeding
Jae Seung Soh, Myeongsook Seo, Kyung-Jo Kim
BMC Gastroenterology.2020;[Epub] CrossRef
Management of colonic polyps: an advancing discipline
Amir Klein, Michael J. Bourke
ANZ Journal of Surgery.2017; 87(5): 327. CrossRef
Massive post‐polypectomy hemorrhage: Successful tulip‐bundle technique with endoloop for hemostasis
Hsu‐Heng Yen, Chia‐Wei Yang, Shun‐Sheng Wu, Maw‐Soan Soon
Advances in Digestive Medicine.2016; 3(3): 128. CrossRef
Advanced Polypectomy and Resection Techniques
Amir Klein, Michael J. Bourke
Gastrointestinal Endoscopy Clinics of North America.2015; 25(2): 303. CrossRef
Comparison of clipping with and without epinephrine injection for the prevention of post‐polypectomy bleeding in pedunculated colon polyps
Yehyun Park, Tae Joo Jeon, Ji Young Park, Soo Jung Park, Jae Hee Cheon, Tae Il Kim, Won Ho Kim, Sung Pil Hong
Journal of Gastroenterology and Hepatology.2015; 30(10): 1499. CrossRef
Endoscopic haemostasis: An overview of procedures and clinical scenarios
Jérémie Jacques, Romain Legros, Stanislas Chaussade, Denis Sautereau
Digestive and Liver Disease.2014; 46(9): 766. CrossRef
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Andres Sanchez-Yague, Tonya Kaltenbach, Gottumukkala Raju, Roy Soetikno
Gastroenterology Clinics of North America.2013; 42(3): 459. CrossRef
A Cost-efficacy Decision Analysis of Prophylactic Clip Placement After Endoscopic Removal of Large Polyps
Neehar D. Parikh, Kyle Zanocco, Rajesh N. Keswani, Andrew J. Gawron
Clinical Gastroenterology and Hepatology.2013; 11(10): 1319. CrossRef
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Laura Borodyansky, John R. Saltzman
Clinical Gastroenterology and Hepatology.2013; 11(10): 1333. CrossRef

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Reviews

Korean Guidelines for Postpolypectomy Colonoscopy Surveillance: Dong-Hoon Yang, Sung Noh Hong, Young-Ho Kim, Sung Pil Hong, Sung Jae Shin, Seong-Eun Kim, Bo In Lee, Suck-Ho Lee, Dong Il Park, Hyun-Soo Kim, Suk-Kyun Yang, Hyo Jong Kim, Se Hyung Kim, Hyun Jung Kim, Multi-Society Task Force for Development of Guidelines for Colorectal Polyp Screening, Surveillance and Management; Clin Endosc 2012;45(1):44-61. Published online March 31, 2012; DOI: https://doi.org/10.5946/ce.2012.45.1.44

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Postpolypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. In this report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy and we elucidated the high risk findings of the index colonoscopy as follows: 3 or more adenomas, any adenoma larger than 10 mm, any tubulovillous or villous adenoma, any adenoma with high-grade dysplasia, and any serrated polyps larger than 10 mm. Surveillance colonoscopy should be performed five years after the index colonoscopy for those without any high-risk findings and three years after the index colonoscopy for those with one or more high risk findings. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polypectomy, the patient's general condition, and family and medical history.

Citations

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Korean Guideline for Colonoscopic Polypectomy: Suck-Ho Lee, Sung Jae Shin, Dong Il Park, Seong-Eun Kim, Hae Jeong Jeon, Se Hyung Kim, Sung Pil Hong, Sung Noh Hong, Dong-Hoon Yang, Bo In Lee, Young-Ho Kim, Hyun-Soo Kim, Hyun Jung Kim, Suk-Kyun Yang, Hyo Jong Kim, Multi-Society Task Force for Development of Guidelines for Colorectal Polyp Screening, Surveillance and Management; Clin Endosc 2012;45(1):11-24. Published online March 31, 2012; DOI: https://doi.org/10.5946/ce.2012.45.1.11

Abstract PDF Supplementary Material PubReader ePub

There is indirect evidence to suggest that 80% of colorectal cancers (CRC) develop from adenomatous polyps and that, on average, it takes 10 years for a small polyp to transform into invasive CRC. In multiple cohort studies, colonoscopic polypectomy has been shown to significantly reduce the expected incidence of CRC by 76% to 90%. Colonoscopic polypectomy is performed frequently in primary outpatient clinics and secondary and tertiary medical centers in Korea. However, there are no evidence-based, procedural guidelines for the appropriate performance of this procedure, including the technical aspects. For the guideline presented here, PubMed, Medline, and Cochrane Library literature searches were performed. When little or no data from well-designed prospective trials were available, an emphasis was placed on the results from large series and reports from recognized experts. Thus, these guidelines for colonoscopic polypectomy are based on a critical review of the available data as well as expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data become available. This guideline is intended to be an educational device to provide information that may assist endoscopists in providing care to patients. This guideline is not a rule and should not be construed as a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions for any particular case involve a complex analysis of the patient's condition and the available courses of action.

Citations

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Modified underwater endoscopic mucosal resection for intermediate-sized sessile colorectal polyps
Dong Hyun Kim, Seon-Young Park, Hye-Su You, Yong-Wook Jung, Young-Eun Joo, Dae-Seong Myung, Hyun-Soo Kim, Nah Ihm Kim, Seong-Jung Kim, Jae Kyun Ju
Frontiers in Medicine.2023;[Epub] CrossRef
Endoscopic treatment of colorectal polyps and early colorectal cancer
Yunho Jung
Journal of the Korean Medical Association.2023; 66(11): 642. CrossRef
Circumferential submucosal incision prior to endoscopic mucosal resection versus conventional endoscopic mucosal resection for colorectal lesions with endoscopic features of sessile serrated lesions
Chang Kyo Oh, Bo-In Lee, Sung Hak Lee, Seung-Jun Kim, Han Hee Lee, Chul-Hyun Lim, Jin Su Kim, Yu Kyung Cho, Jae Myung Park, Young-Seok Cho, In Seok Lee, Myung-Gyu Choi
Surgical Endoscopy.2022; 36(3): 2087. CrossRef
Polypectomy for Diminutive and Small Colorectal Polyps
Melissa Zarandi-Nowroozi, Roupen Djinbachian, Daniel von Renteln
Gastrointestinal Endoscopy Clinics of North America.2022; 32(2): 241. CrossRef
Risk of post-polypectomy bleeding after endoscopic mucosal resection in patients receiving antiplatelet medication: comparison between the continue and hold groups
Sang Hyun Park, Soo-Kyung Park, Hyo-Joon Yang, Yoon Suk Jung, Jung Ho Park, Chong Il Sohn, Dong Il Park
Surgical Endoscopy.2022; 36(9): 6410. CrossRef
Hot snare polypectomy versus endoscopic mucosal resection for small colorectal polyps: a randomized controlled trial
Seung-Jun Kim, Bo-In Lee, Eun Sun Jung, Joon Sung Kim, Sun-Young Jun, Woohyeon Kim, Hyoju Ham, Minah Kim, Sung Hak Lee, Han Hee Lee, Jae Myung Park, Myung-Gyu Choi
Surgical Endoscopy.2021; 35(9): 5096. CrossRef
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The Korean Journal of Gastroenterology.2020; 76(6): 282. CrossRef
Endoscopic Submucosal Dissection for Colitis-Associated Dysplasia
Dong-Hoon Yang, Imelda Rey
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Prospective analysis of delayed colorectal post-polypectomy bleeding
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Association between the Position of Colorectal Polyps and Clinical Outcomes of Polypectomy: Focused on Procedure Time, Complication and Histopatholgic Result
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A Case of Postpolypectomy Coagulation Syndrome Had a Hemicolectomy: Song Yi Song, M.D., Young Kyung Sung, M.D., Hye Jeong Kim, M.D., Soyoung Bae, M.D., Silvia Park, M.D., Yong Beom Cho, M.D.*, Jin Yong Kim, M.D. and Seung Min Chung, M.D.; Korean J Gastrointest Endosc 2010;41(4):236-239. Published online October 30, 2010

Abstract PDF: Colonoscopy is commonly used as a screening tool for colorectal polyps and cancer. It also offers a chance to remove polyps via the polypectomy technique. Colonoscopic polypectomy is a relatively safe procedure, yet there is the possibility of serious complications such as perforation and bleeding. Postpolypectomy coagulation syndrome presents with pain, fever, an elevated white blood cell count and signs of peritoneal irritation, and usually within 12 hours of the procedure. No free air is seen on plain films or a CT scan, which is different from frank bowel perforation. The management of postpolypectomy coagulation syndrome includes fasting, antibiotics and intravenous hydration. We report here on a case of a 53-year-old woman who underwent right hemicolectomy because she presented with fever, signs of peritoneal irritation and shock after colonoscopic polypectomy. The final diagnosis was postpolypectomy coagulation syndrome as there was no perforation in the resected specimen. (Korean J Gastrointest Endosc 2010;41:236-239)

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Partial Duodenal Obstruction Caused by an Impacted Gastritis Cystica Polyposa: Ju Hwan Kim, M.D., Chang Il Kwon, M.D., Seung Won Koo, M.D., Kwang Ho Yoo, M.D., Gwang Il Kim, M.D.*, So Young Chong, M.D., Kwang Hyun Ko, M.D. and Sung Pyo Hong, M.D.; Korean J Gastrointest Endosc 2010;41(4):228-231. Published online October 30, 2010

Abstract PDF: Gastritis cystica polyposa is an uncommon lesion that usually occurs at the gastroenterostomy site, but it may also develop in the non-operated stomach. This malady is characterized by polypoid mucosal changes with hyperplasia and cystic dilatation of glands that infiltrate into the submucosal layer. We report here on a case of gastritis cystica polyposa that presented as a mass impacted in the duodenum in a 63-year-old male, and this patient had been admitted for evaluation of progressive epigastric fullness and dyspepsia. Esophagogastroduodenoscopy revealed that the partial duodenal obstruction was caused by impaction of a huge polypoid mass with a stalk that originated from the lower body of the stomach. We fished out the impacted mass with a forceps catheter while holding the neck with a snare catheter. Thereafter, an endoloop was applied to the stalk of mass, and this was followed by polypectomy using a snare catheter. (Korean J Gastrointest Endosc 2010;41:228-231)

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A Case of Colonic Intussusception Occurring after Colonoscopic Polypectomy: Sa Il Kim, M.D., Yong Cheol Jeon, M.D., Gil Woo Lee, M.D., Young Taek Kim, M.D., Tae Yeob Kim, M.D., Chang Soo Eun, M.D., Dong Soo Han, M.D. and Joo Hyun Sohn, M.D.; Korean J Gastrointest Endosc 2010;41(3):172-175. Published online September 30, 2010

Abstract PDF: Intestinal intussusception in adults is a rare disease. Most of the cases of adult intussusception are secondary to a definable lesion, and so surgical treatment generally needed. Intussusception that occurs after colonoscopic polypectomy is apparently a rare malady. A 77-year old man undergoing colonoscopic polypectomy was diagnosed as having colonic intussusception at the hepatic flexure. As there was no clinical improvement with conservative treatment, he underwent segmental resection of the ascending and transverse colon. Pathologic examination revealed that the colonoscopic polypectomy site was a leading point of the intussusception. (Korean J Gastrointest Endosc 2010;41:172-175)

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A Case of Hamartomatous Polyp without Peutz-Jeghers Syndrome Arising from Appendix: Wee Sik Sohn, M.D., Ju Sang Park, M.D., Ji Eun Kim, M.D., Bong Hwan Kim, M.D., Seung Hee Yoo, M.D. and Eun Mee Han, M.D.*; Korean J Gastrointest Endosc 2010;41(1):36-40. Published online July 31, 2010

Abstract PDF: Peutz-Jeghers syndrome is a familial syndrome consisting of mucocutaneous pigmentation and gastrointestinal polyposis and appears to be inherited as a single pleiotropic autosomal dominant gene with variable and incomplete penetrance. Cases of hamartomatous polyps of the Peutz-Jeghers type without Peutz-Jeghers syndrome have only rarely been reported. Moreover, only one case of a Peutz-Jeghers polyp at the appendix has been reported; it was resected by appendectomy. We report here on a case of a 45 year old man who had a hamartomatous polyp of the Peutz-Jeghers type arising from the appendix. The polyp was successfully removed by endoscopic polypectomy. To our knowledge, this is the first case of a hamartomatous polyp of the Peutz-Jeghers type that originated from the appendix and that was resected endoscopically. (Korean J Gastrointest Endosc 2010;41:36-40)

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Risk Factors for Delayed Bleeding after Colonoscopic Polypectomy: Woo Jin Han, M.D., Yoon Jae Kim, M.D., Jung Gon Kim, M.D., Tae Kyung Kim, M.D., Seo Young Lee, M.D., Moon Sook Cho, M.D., Jun Won Chung, M.D., Dong Kyun Park, M.D., Ki Baik Hahm, M.D., Yun Soo Kim, M.D. and Ju Hyun Kim, M.D.; Korean J Gastrointest Endosc 2010;40(3):164-169. Published online March 30, 2010

Abstract PDF: Background
/Aims: The aim of this study was to identify risk factors for delayed bleeding after colonoscopic polypectomy.
Methods
3,530 polypectomies in 1,542 patients were evaluated. Risk factors were identified among patient-related factors (age, sex, comorbidity, anticoagulants, antiplatelets), polyp-related factors (size, shape, location, histology), and procedure-related factors (experience of the endoscopist, sedation, resection method).
Results
Delayed bleeding occurred in 26 lesions (0.7%) of 24 patients (1.6%). Polyp-based multivariate analysis revealed that polyp size greater than 15 mm (OR, 2.882; 95% CI, 1.106 to 7.506; p=0.030) and sedation-free colonoscopy (OR, 2.606; 95% CI, 1.116 to 6.084; p=0.027) were significant risk factors for delayed bleeding after polypectomy. In colonoscopy-based analysis, hypertension increased the risk of delayed bleeding after polypectomy (OR, 2.938; 95% CI, 1.009 to 8.557; p=0.048).
Conclusions
Large polyp size, sedation-free colonoscopy, and hypertension are associated with delayed bleeding after colonoscopic polypectomy. (Korean J Gastrointest Endosc 2010;40:164-169)

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Endoscopic Polypectomy of Small Intestinal Peutz-Jeghers Polyps with Double Balloon Enteroscopy: Mi-Young Kim, M.D., Jeong-Sik Byeon, M.D., Kee Don Choi, M.D., Byong Duk Ye, M.D., Dong-Hoon Yang, M.D., Soon Man Yoon, M.D., Kyung-Jo Kim, M.D., Seung-Jae Myung, M.D., Suk-Kyun Yang, M.D. and Jin-Ho Kim, M.D.; Korean J Gastrointest Endosc 2009;39(6):338-345. Published online December 30, 2009

Abstract PDF: Background
/Aims: Small intestinal polyps in patients with Peutz-Jeghers (PJ) syndrome cause therapeutic difficulties because of the necessity for repeated laparotomy. We evaluated the short-term outcomes and long-term usefulness of double balloon enteroscopy (DBE) polypectomy for treating small intestinal PJ polyps.
Methods
We retrospectively reviewed 10 patients with PJ syndrome (M：F=7：3, mean age 22.7 years) and whose small intestinal polyps were resected with DBE between January 2005 and July 2008. We analyzed their clinical, endoscopic and pathologic features, the short-term outcomes and the long-term follow-up results.
Results
Among 10 patients, 2 complained hematochezia and 2 presented with intussusceptions. DBE polypectomy was performed by the oral route in 4 patients, by the anal route in 1 and by both routes in 5 without significant complications, except for only one perforation. The polyps were 0.5∼6 cm in size and most of them were pedunculated. The histopathology revealed hamartomatous polyps in most cases. Follow-up small bowel series was performed in 6 of 10 patients, and 3 showed remnant polyps. Two of them underwent repeated DBE polypectomy without significant complications.
Conclusions
We suggest that DBE polypectomy is a useful treatment for PJ small intestinal polyps because of the good short-term outcome and the effectiveness of repeated polypectomy for the remnant or recurrent polyps. (Korean J Gastrointest Endosc 2009;39:338-345)

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Endoscopic Polypectomy of Primary Rectal Mature Teratoma: A Case Report: Jongha Park, M.D., Jeong-Sik Byeon, M.D., Jeong-Hyeon Jo, M.D.*, Kyung-Jo Kim, M.D., Byong Duk Ye, M.D., Seung-Jae Myung, M.D., Suk-Kyun Yang, M.D. and Jin-Ho Kim, M.D.; Korean J Gastrointest Endosc 2009;39(5):308-312. Published online November 30, 2009

Abstract PDF: Teratoma is a type of benign germ cell tumor that often contains several different types of tissue such as hair, muscle and bone, and these tissues arise from the three germinal layers. It occurs most often in the tailbones of children, the ovaries of women and the testicles of men. Primary rectal teratoma is extremely rare. We report here on a case of a 49-year-old woman with a primary rectal teratoma, and this was incidentally found during routine health screening. The rectal teratoma was a 15 mm-sized pedunculated polyp with a short stalk at the rectum, about 15 cm from anal verge as seen on CT colonography. On sigmoidoscopy and EUS, a fat and calcium containing well-defined polypoid lesion was noted in the upper rectum, with a narrow stalk attached to the colonic wall. The tumor was successfully excised by endoscopic polypectomy in order to obtain the histologic diagnosis and administer the proper treatment. (Korean J Gastrointest Endosc 2009;39:308-312)

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Rectal Leiomyoma Diagnosed by Endoscopic Ultrasonography and Endoscopic Polypectomy: Sung Whan Cho, M.D., Hyung Yook Kim, M.D.* and Ung Suk Yang, M.D.; Korean J Gastrointest Endosc 2009;38(3):151-155. Published online March 30, 2009

Abstract PDF: Leiomyoma of the rectum is a rare tumor and it usually present in 40 to 60 year-old individuals, and it is more frequent in men. It originates from either the muscularis mucosa or muscularis externa and those arising from the muscularis mucosa are typically small and they are identified incidentally in patients who are undergoing sigmoidoscopy. In contrast, the larger leiomyomas arising from the muscularis externa generally present symptoms that are consistent with rectal stenosis or a rectal mass. Endoscopic ultrasonography can help to define the tumor location, extension and size. Surgical resection is the treatment for most leiomyomas of the rectum, but endoscopic electroexcision is a safe and appropriate treatment for small polypoid rectal leiomyoma. We report here on a case of a semipedunculated rectal leiomyoma in a 59 year-old female patient. It was found incidentally during a colonoscopic examination and it was diagnosed by endoscopic ultrasonography. We performed endoscopic mucosal resection with colonoscopic snare electrocoagulation. (Korean J Gastrointest Endosc 2009;38:151-155)

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A Case of Delayed Massive Hemorrhage after Endoscopic Resecting a Rectal Carcinoid Tumor: So Mi Kim, M.D., Se Young Yun, M.D., Hoon Choi, M.D., Jae Huan Kong, M.D. and Sung Soo La, M.D.; Korean J Gastrointest Endosc 2009;38(2):111-115. Published online February 27, 2009

Abstract PDF: Endoscopic resection is currently accepted as a standard therapy for colon polyp because of its safety and efficiency. The indications for endoscopic resection have been expanded to treat mucosal colon cancer and submucosal tumor. The major complications of endoscopic resection are hemorrhage, perforation and post- polypectomy coagulation syndrome. Hemorrhage is the most common complication, and this can occur immediately following colonoscopic polypectomy or it can be delayed after completion of the procedure. Delayed hemorrhage usually occurs within 7 days and this can stop by itself or the hemorrhage can be controlled endoscopically in the majority of patients, with only the unusual and serious cases requiring transfusion, angiography and surgery. We experienced a case of delayed massive hemorrhage with hypotension that required transfusion 12 days after performing endoscopic resection for rectal carcinoid tumor. We report here on this case to provide a good example and to place emphasis on delayed massive hemorrhage after endoscopic resection. (Korean J Gastrointest Endosc 2009;38: 111-115)

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Histological Quality of Small Polyps Resected Using Different Electric Currents in a Colonoscopic Polypectomy: Si Hyung Lee, M.D., Byung Ik Jang, M.D., Tae Nyeun Kim, M.D. and Joon Hyuk Choi, M.D.*; Korean J Gastrointest Endosc 2008;37(3):174-178. Published online September 30, 2008

Abstract PDF: Background
/Aims: Most polyps encountered during a colonoscopic polypectomy are small. Thus, accurate evaluation of small polyp histology is important in the decision-making process. The aim of this study was to assess and compare the histological quality of polyps obtained by the use of snare polypectomy with two different electric currents. Methods: Consecutive polyps less than 1 cm were identified and removed by use of either the blend mode (Blended mode, Circon, BC-200) or automatic cutting and coagulation mode (Endocut Q mode, effect 3, 40 watts, ERBE, VAIO-300). An experienced gastrointestinal pathologist evaluated the specimens for cautery damage, margin, architecture, presence of muscularis mucosa and general histological quality. Results: Sixty-six patients (77.2% men; mean age, 60.2±9.2 years) underwent 109 polypectomies (53 using the blended mode and 56 using the Endocut Q mode; mean polyp diameter, 0.87±0.17 mm). Age, gender, location, diameter and the histology of the polyp was not different with the use of both methods. The cautery amount (≥2) with use of the blended mode was not significantly different than with the use of the Endocut mode (50.9% vs. 39.2%, p=0.22). The cautery degree, margin, architecture, presence of muscular mucosa and overall histological quality was not different with the use of both methods. Conclusions: The histological quality of polyps less than 1 cm obtained by use of either the blended mode or Endocut Q mode was not different. (Korean J Gastrointest Endosc 2008;37:174- 178)

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A Case of Laterally Spreading Tumor Resected with Double Balloon Enteroscopy in a Severely Redundant Colon: Jae Hong Ahn, M.D., Dong Il Kim, M.D., Ja Seol Koo, M.D., Hong Sik Lee, M.D., Sang Woo Lee, M.D., Chang Duck Kim, M.D., Jai Hyun Choi, M.D. and Ho Sang Rhu, M.D.; Korean J Gastrointest Endosc 2008;37(2):137-141. Published online August 30, 2008

Abstract PDF: The incidence of colon cancer and cancer-related deaths has been increased in Korea. Because most colon cancers arise from colonic adenomatous polyps, it is important to detect these early and to resect such lesions, and so the incidence of endoscopic polypectomy has increased in Korea since 1970's. At present, conventional colonoscopy is the standard for evaluating the colon, and especially for the screening and treatment of colon tumor. However, the entire colon cannot be visualized during conventional colonoscopy in 5∼15% of patients due to a redundant colon, an excessive loop or a history of abdominal surgery. To overcome these difficulties, many radiologic and endoscopic studies have been conducted and there are several recent reports that double balloon enteroscopy has been successfully used in cases of failed conventional colonoscopy. We report here on a case of laterally spreading tumor that was resected with double balloon enteroscopy in a severely redundant colon. (Korean J Gastrointest Endosc 2008;37:137-141)

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Endoscopic Resection of a Large Colonic Lipoma: Hye Suk Son, M.D., Young Seok Cho, M.D., Jin Soo Kim, M.D., Hyung Keun Kim, M.D., Chang Hyuk Ahn, M.D.*, Sung Soo Kim, M.D., Hiun Suk Chae, M.D. and Kyu Yong Choi, M.D.; Korean J Gastrointest Endosc 2008;37(2):122-126. Published online August 30, 2008

Abstract PDF: Although colonic lipomas constitute the most common nonepithelial neoplasms of the gastrointestinal tract, colonic lipomas are rare benign tumors. Most colonic lipomas are asymptomatic and are incidentally identified at the time of endoscopy or surgery. Lipomas may cause symptoms such as bleeding, obstruction or intussusception when the size of a tumor exceeds 2 cm. Surgical resection is recommended for larger lipomas to relieve symptoms or exclude a malignancy. There are few published reports on the endoscopic removal of colonic lipomas. Endoscopic snare polypectomy has been used to treat clinically symptomatic colonic lipomas. However, removal of lipomas 2 cm or greater in diameter has been associated with a greater risk of perforation. Using a detachable snare or hemoclipping may reduce the risk of complications after a polypectomy. We report a case of a large colonic lipoma that was treated with endoscopic polypectomy using a detachable snare and hemoclipping. (Korean J Gastrointest Endosc 2008;37:122-126)

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Clinical Observation of Colorectal Polyps: Won Ook Ko, M.D., Jong In Kim, M.D., Ju Yeon Nam, M.D., Jung Im Jung, M.D., Jin Kwang An, M.D., Kwang Jin Kim, M.D., Hyung Wook Kim, M.D., Won Il Park, M.D. and Ung Suk Yang, M.D.; Korean J Gastrointest Endosc 2008;37(2):105-111. Published online August 30, 2008

Abstract PDF: Background/Aims: The detection and removal of colorectal polyps are important for secondary prevention of colorectal cancer. We investigated the characteristics and histopathologic finding of polyps to better plan their management. Methods: We analyzed 334 patients who underwent polypectomies for 770 colorectal polyps between October, 2005 and April, 2007 at Bong Seng Memorial Hospital. Results: Colorectal polyps were frequent in the sixth decade in both sexes. The ratio of male to female patients was 1.72:1. Abdominal pain/discomfort was the most common symptom (34.4%), and the most common site of polyp localization was the rectosigmoid colon. Histopathologic examination showed tubular adenomas (54.6%), hyperplastic polyps (36.4%), and inflammatory polyps (5.6%). Adenomatous polyps were more common in patients with multiple polyps than in patients with a single polyp. Adenomatous polyps with villous histology were more common in patients with large polyps than in patients with small polyps. Non-neoplastic polyps were common before the fifth decade. Neoplastic polyps were common past the fifth decade. Conclusions: In this study, tubular adenomas were frequently found on histopathologic examination, sessile type were frequently found on gross examination, and colorectal polyps were found principally in the rectosigmoid colon. Neoplastic polyps were more frequent in patients beyond the fifth decade. There fore colonoscopy examination is recommended for secondary prevention of colon cancer. (Korean J Gastrointest Endosc 2008;37:105-111)

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A Case of Gastric Huge Intramucosal Hematoma after Snare Polypectomy: Chang Kyun Lee, M.D., Jae Young Jang, M.D., Young Hwangbo, M.D., Jaejun Shim, M.D., Sung Hoon Jung, M.D., Seok Ho Dong, M.D., Hyo Jong Kim, M.D., Byung-Ho Kim, M.D.,Young Woon Chang, M.D. and Rin Chang, M.D.; Korean J Gastrointest Endosc 2008;36(4):219-223. Published online April 30, 2008

Abstract PDF: Endoscopic polypectomy is a widely used therapeutic modality for the treatment of polypoid lesions in the gastrointestinal tract. Postpolypectomy bleeding is the most common procedure-related complication. Bleeding can occur immediately after the polypectomy or be delayed from hours to up to days. The severity of bleeding ranges from slight oozing to spurting arterial bleeding that requires immediate endoscopic hemostasis. Because severe hemorrhage can be a cause of repeat endoscopy, blood transfusion, hospitalization or surgery, endoscopists must carefully observe the patient's symptoms and hemodynamic status after an endoscopic polypectomy. Here, we report a large intramucosal hematoma and subsequent huge ulcer in the stomach as a rare complication of endoscopic snare polypectomy. (Korean J Gastrointest Endosc 2008;36: 219-223)

2,757 View
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The Colonoscopic Miss Rates of Colorectal Polyps as Determined by a Polypectomy: Se Young Park, M.D., Won Moon, M.D., Seun Ja Park, M.D., Moo In Park, M.D., Kyu Jong Kim, M.D., Sun Jung Kim, M.D., Hong Jun You, M.D. and Woo Seong Jeon, M.D.; Korean J Gastrointest Endosc 2008;36(3):132-137. Published online March 30, 2008

Abstract PDF: Background
/Aims: Colonoscopy is the most effective method to detect and remove colonic polyps and for colorectal cancer screening and prevention. However, polyps are frequently missed during colonoscopy. The aim of this study was to determine the miss rates of polyps by colonoscopy and to evaluate the factors that affect the miss rates. Methods: Within sixty days after a first-time colonoscopy, consecutive polypectomies were performed in 317 patients who had one or more colon polyps. Results: The overall miss rate for polyps was 26.6%. As the withdrawal time increased, the number of polyps detected on the first colonoscopy decreased, and the miss rate decreased significantly (respectively p=0.000, p=0.028). The withdrawal time for an expert operator was shorter than the withdrawal time for a beginner operator (p=0.001). The miss rate for a beginner operator and expert operator was not different (p=0.271) due to interference with withdrawal time. The most frequent location of a polyp was the ascending colon and the most frequent size of a polyp was ≤5 mm. Conclusions: Although colonoscopy is the gold standard for colorectal polyp detection, it is imperfect even when meticulously performed. To reduce the miss rates of polyps, it is important that a careful examination with sufficient withdrawal time is performed, the colonoscopy is complete to the cecum, and that the bowel preparation is adequate. (Korean J Gastrointest Endosc 2008;36:132-137)

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A Case of Febrile Colonic Tuberculosis that Became Defervescence after Colonoscopic Polypectomy: Seong Deuk Baek, M.D., Jung Hyun Lee, M.D., Jung Il Seo, M.D. and Chang Woo Lee, M.D.; Korean J Gastrointest Endosc 2008;36(1):31-35. Published online January 30, 2008

Abstract PDF: The clinical manifestations, radiological and endoscopic findings of colonic tuberculosis are non-specific. A diagnosis of colonic tuberculosis is usually difficult because the condition can mimic tumors. Fever occurs in 60∼85% of patients with tuberculosis, which is one of the important signs of disease activity, and usually resolves by the second week after beginning treatment. However, there are some patients who remain febrile beyond a reasonable treatment period or develop fever during treatment. Such cases raise issues, such as cytokine release from tuberculous granuloma, drug induced fever, drug resistance, and drug malabsorption. We encountered a patient with polypoid colonic tuberculosis who presented with prolonged fever after commencing treatment and became defervescence after a colonoscopic polypectomy. We report this case with a review of the relevant literature. (Korean J Gastrointest Endosc 2008;36:31-35)

2,316 View
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A Survey on the Interval of Post-polypectomy Surveillance Colonoscopy: Mun Su Kang, M.D., Dong Il Park, M.D., Jung Ho Park, M.D., Hong Joo Kim, M.D., Yong Kyun Cho, M.D., Chong Il Sohn, M.D., Woo Kyu Jeon, M.D. and Byung Ik Kim, M.D.; Korean J Gastrointest Endosc 2006;33(6):339-345. Published online December 30, 2006

Abstract PDF: Background
/Aims: Colonoscopy is the golden standard used as a surveillance test and screen for colon cancer, and the current demand for colonoscopy exceeds its availability. This study is an assessment of the colonoscopic surveillance intervals currently practiced. Methods: A multiple choice survey of the colonoscopic surveillance interval used in six case scenarios [hyperplastic polyp; two 0.5 cm tubular adenomas (TAs); a 1.5 cm TA; 0.8 cm triple TAs; a 1.5 cm TA with high grade dysplasia; current normal exam after polypectomy of a ＜1 cm sized TA 3 years ago] was sent via e-mail to members of the KASID. Results: A total of 131 colonoscopists (104 men, 27 women) replied, and the mean age of the respondents was 36 years (range 28∼58). All respondents were board- certified in their respective specialties (internal medicine 75, general surgery 3, and GI subspecialty 53). When compared with the AGA guidelines, 90.1∼99.2% of the respondents performed the first post-polypectomy surveillance colonoscopy prematurely, and 75.6% of respondents performed the second surveillance prematurely. Conclusions: Most post-polypectomy surveillance colonoscopies were performed prematurely. It is quite possible that unnecessary surveillance may account for a significant portion of the demand for colonoscopy. (Korean J Gastrointest Endosc 2006;33:339⁣345)

2,923 View
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A Case of Polypoid Arteriovenous Malformation Treated by Polypectomy with Detachable Snare: Ji Min Jung, M.D., Ki-Nam Shim, M.D., Moon Young Choi, M.D., Hyun Joo Song, M.D., Kum Hei Ryu, M.D., Hye Jung Yeom, M.D., Tae Hun Kim, M.D., Sung-Ae Jung, M.D., Kwon Yoo, M.D., Il Hwan Moon, M.D. and Si Nae Lee, M.D.*; Korean J Gastrointest Endosc 2006;33(5):313-317. Published online November 30, 2006

Abstract PDF: Arteriovenous malformations are degenerative lesions of the gastrointestinal tract that occur with a frequency that increases with increasing age. Although the bleeding caused by arteriovenous malformations is typically chronic, slow, intermittent and recurrent, 15% of patients with arteriovenous malformations present with massive bleeding. Any part of the gastrointestinal tract can be involved and arteriovenous malformations usually appear on endoscopy as either flat or elevated discrete bright red mucosal lesions. There are a few cases of colonic arteriovenous venous malformations with a polypoid appearance with some of their endoscopic treatments resulting in profuse bleeding from the remnant stalk. We encountered a case of a polypoid arteriovenous malformation in the colon of a 69-year-old patient with active gastrointestinal bleeding. The patient was treated successfully by an endoscopic polypectomy with a detachable snare. (Korean J Gastrointest Endosc 2006;33:313⁣317)

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Endoscopic Removal of Bleeding Duodenal Lipoma Using a Detachable Snare: Gun-Min Kim, M.D., Woo-Chul Chung, M.D., Seong-Su Hwang, M.D.*, Kang-Moon Lee, M.D., Bo-In Lee, M.D., U-Im Chang, M.D., Jin-Mo Yang, M.D., Kyu-Yong Choi, M.D. and In-Sik Chung, M.D.; Korean J Gastrointest Endosc 2006;33(2):100-104. Published online August 30, 2006

Abstract PDF: Duodenal lipomas are relatively uncommon and asymptomatic unless they are large. Tumors greater than 4 cm in diameter can cause obstructive symptoms as a result of intussusception necessitating a surgical resection. However, acute upper gastrointestinal bleeding is an extremely rare complication. Duodenal lipomas are most often submucosal but they can also be subserosal. Their shape can vary, and they can be either sessile or pedunculated. The overlying mucosa is usually normal but it may be ulcerated. Those that cause symptoms require treatment. Endoscopic snare polypectomy has been used to treat clinically symptomatic lipomas. A detachable snare may reduce the risk of complications after a polypectomy, including bleeding and perforation. We report a case of duodenal lipoma accompanied by massive upper GI bleeding that was treated by an endoscopic polypectomy using a detachable snare. (Korean J Gastrointest Endosc 2006;33:100⁣104)

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Submucosal Saline-Epinephrine Injection in Colonoscopic Polypectomy: What is the Proper Application?: Sang Huyb Lee, M.D., Kyoung Soo Lee, M.D., Yeol Keun Woo, M.D., Byong Duk Ye, M.D., Jong Yeul Lee, M.D., Su Cheol Park, M.D., Kwang Hyuck Lee, M.D.*, Young Soo Park, M.D.*, Jin-Hyeok Hwang, M.D.*, Sook Hyang Jung, M.D.*, Nayoung Kim, M.D.*, Dong Ho Lee, M; Korean J Gastrointest Endosc 2006;33(2):77-84. Published online August 30, 2006

Abstract PDF: 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 (≤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. (Korean J Gastrointest Endosc 2006;33:77⁣84)

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A Case of Granular Cell Tumor of the Colon Treated by Colonoscopy: Nam Young Park, M.D., Kyu-Jong Kim, M.D., Yoon Jeong Kim, M.D., Ji Hun Roh, M.D., Dae Gwan Im, M.D., Ji Hyun Nam, M.D., Won Moon, M.D., Moo In Park, M.D., Seun Ja Park, M.D. and Bong Kwon Cheon, M.D.*; Korean J Gastrointest Endosc 2006;32(1):67-70. Published online January 30, 2006

Abstract PDF: Granular cell tumor (GCT) is a relatively rare benign tumor that can be located anywhere throughout the body, but it is uncommon in the gastrointestinal tract, and especially in the colon and rectum. A 41-year-old man visited our hospital with a three-month history of intermittent abdominal discomfort at the left lower quadrant area. Colonoscopic examination revealed a hemispheric, submucosal lesion, about 1.5⁓1.2 cm in size, on the opposite side of the ileocecal valve in the proximal ascending colon. The tumor was removed by an endoscopic snare without any immediate complication. The pathologic findings revealed spindled or polygonal large cells that were positive for S-100, neuron-specific enolase and vimentin, and they were negative for smooth muscle actin and desmin, which was consistent with granular cell tumor. We report here on a case of granular cell tumor of the colon that was successfully treated with endoscopic polypectomy. (Korean J Gastrointest Endosc 2006;32:67⁣ 70)

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Tubular Adenoma of the Common Bile Duct: Endoscopic Diagnosis and Treatment: Jin Hyuck Chang, M.D., Dong Ki Lee, M.D., Tae Woong No, M.D., Min Su Kim, M.D., Kuen Man Lee, M.D., Se Joon Lee, M.D., Sang In Lee, M.D. and Seok Woo Yang, M.D.*; Korean J Gastrointest Endosc 2005;31(3):193-197. Published online September 30, 2005

Abstract PDF: Biliary adenoma of the common bile duct is a rare disease found in biliary tract encounterd in biliary mass lesion, and it is difficult to differentiate from their malignant counterparts. Symptoms and signs of these tumors can mimic choleliathiasis and malignant tumors. Therefore, this tumor is rarely diagnosed preoperatively. In addition, there has been no reported case of a tubular adenoma of the common bile duct in Korea, until recently. We experienced a case of tubular adenoma of the common bile duct, which was diagnosed and partially resected by percutaneous transhepatic cholangioscopy. The patient was a 84-year-old male who showed abnormal liver function test. Abdominal ultrasonography showed a dilated common bile duct, and a soft tissue was observed on endoscopic retrograde cholangiography. This was initially thought as a stone, but it became partially detachable from the common bile duct during an endoscopic retrograde cholangioscopic basket removal. The mass lesion was partially resected by a percutaneous transhepatic cholangioscopic snare. This resected tissue was confirmed as a tubular adenoma. (Korean J Gastrointest Endosc 2005;31:193⁣197)

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Tubular Adenoma of the Common Bile Duct: Endoscopic Diagnosis and Treatment: Jin Hyuck Chang, M.D., Dong Ki Lee, M.D., Tae Woong No, M.D., Min Su Kim, M.D., Kuen Man Lee, M.D., Se Joon Lee, M.D., Sang In Lee, M.D. and Seok Woo Yang, M.D.*; Korean J Gastrointest Endosc 2005;31(3):193-197. Published online September 30, 2005

Abstract PDF: Biliary adenoma of the common bile duct is a rare disease found in biliary tract encounterd in biliary mass lesion, and it is difficult to differentiate from their malignant counterparts. Symptoms and signs of these tumors can mimic choleliathiasis and malignant tumors. Therefore, this tumor is rarely diagnosed preoperatively. In addition, there has been no reported case of a tubular adenoma of the common bile duct in Korea, until recently. We experienced a case of tubular adenoma of the common bile duct, which was diagnosed and partially resected by percutaneous transhepatic cholangioscopy. The patient was a 84-year-old male who showed abnormal liver function test. Abdominal ultrasonography showed a dilated common bile duct, and a soft tissue was observed on endoscopic retrograde cholangiography. This was initially thought as a stone, but it became partially detachable from the common bile duct during an endoscopic retrograde cholangioscopic basket removal. The mass lesion was partially resected by a percutaneous transhepatic cholangioscopic snare. This resected tissue was confirmed as a tubular adenoma. (Korean J Gastrointest Endosc 2005;31:193⁣197)

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A Case of Endoscopic Polypectomy Using a Hand-Made Detachable Snare Made of Nylon Fishing Line: Jong Chun Nah, M.D., Jong Sung Lee, M.D., Young Kwan Kim, M.D., Jin Kwang Lee, M.D., Seong Eun Kim, M.D., Soo Hyung Ryu, M.D., Jung Whan Lee, M.D.,You Sun Kim, M.D. and Jeong Seop Moon, M.D.; Korean J Gastrointest Endosc 2005;31(3):185-188. Published online September 30, 2005

Abstract PDF: Hemorrhage is the most common complication of polypectomy. Though most bleeding stops spontaneously and can be managed with conservative therapies, some may necessitate intensive therapies. The detachable snare was firstly introduced in 1986. It has been reported that the use of detachable snare can effectively prevent both immediate and delayed bleeding. The detachable snare has been reformed, and now a commercial article is used in practice. But, it is expensive and cannot be used in larger polyps measuring over its fixed size of loop. A hand-made detachable snare made of nylon fishing line was introduced to prevent postpolypectomy bleeding in 2003. We have further improved it and experienced a case of successful removal of a large colonic polyp using our hand-made snare. The hand-made detachable snare is inexpensive and seems to be practical in ligating the polyp regardless of its size. (Korean J Gastrointest Endosc 2005;31:185⁣188)

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A Case of Endoscopic Polypectomy Using a Hand-Made Detachable Snare Made of Nylon Fishing Line: Jong Chun Nah, M.D., Jong Sung Lee, M.D., Young Kwan Kim, M.D., Jin Kwang Lee, M.D., Seong Eun Kim, M.D., Soo Hyung Ryu, M.D., Jung Whan Lee, M.D.,You Sun Kim, M.D. and Jeong Seop Moon, M.D.; Korean J Gastrointest Endosc 2005;31(3):185-188. Published online September 30, 2005

Abstract PDF: Hemorrhage is the most common complication of polypectomy. Though most bleeding stops spontaneously and can be managed with conservative therapies, some may necessitate intensive therapies. The detachable snare was firstly introduced in 1986. It has been reported that the use of detachable snare can effectively prevent both immediate and delayed bleeding. The detachable snare has been reformed, and now a commercial article is used in practice. But, it is expensive and cannot be used in larger polyps measuring over its fixed size of loop. A hand-made detachable snare made of nylon fishing line was introduced to prevent postpolypectomy bleeding in 2003. We have further improved it and experienced a case of successful removal of a large colonic polyp using our hand-made snare. The hand-made detachable snare is inexpensive and seems to be practical in ligating the polyp regardless of its size. (Korean J Gastrointest Endosc 2005;31:185⁣188)

2,171 View
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