Diminutif Poliplerin Endoskopik Tedavisinde Jumbo Forseps ve Soğuk Snare ile Polipektomi Yöntemlerinin Karşılaştırılması

Year 2022, , 93 - 98, 01.03.2022

Mukaddes Tozlu

https://doi.org/10.26453/otjhs.1031817

Abstract

Amaç: Kolonoskopi sırasında bulunan poliplerin çoğu 5 mm’nin altındadır. Polipektomi teknikleri endoskopistler arasında çok değişkendir ve endoskopistin tercihine göre belirlenmektedir. Bu çalışmada diminutif polip (DP) olarak adlandırılan, ≤5 mm poliplerde, jumbo forseps (JFP) ve soğuk snare (CSP) ile yapılan polipektomilerin tam rezeksiyon oranları ve komplikasyonlar yönünden karşılaştırılması amaçlanmıştır.
Materyal ve Metot: Kliniğimizde herhangi bir nedenle kolonoskopi yapılan ve ≤5 mm polip saptanan hastalar; JFP ve CSP grubu olarak iki gruba randomize edildi. Polipektomi yöntemleri komplikasyon ve rezeksiyon açısından karşılaştırıldı.
Bulgular: Toplam 100 polipektomi işlemi (JFP grubu=50 ve CSP grubu=50) analiz edildi. Ortalama hasta yaşı 59,1±11,2 yıldı ve 54'ü (%54) erkekti. Hastaların demografik özellikleri ve polip karakteristikleri gruplar arasında benzerdi. DP'ler için genel tam rezeksiyon oranı, JFP ve CSP grupları arasında önemli ölçüde farklı değildi (%90'a karşı %82, P=0,38). ≤3 mm poliplerde polipektomi süresi CSP grubunda anlamlı olarak uzundu (p=0,008). CSP grubunda %4 minör kanama izlendi ve 4 polip (%8) çıkartılamadı. Komplikasyon oranı CSP grubunda anlamlı olarak yüksek saptandı (p=0,01).
Sonuç: ≤5 mm kolorektal poliplerin eksizyonunda, rezidü açısından JFP ve CSP yöntemlerinin birbirlerine üstünlük sağladıkları gösterilmemiştir, ancak JFP yöntemi ile komplikasyon oranları daha düşük saptanmıştır. 

Keywords

endoskopik polipektomi, jumbo forseps, soğuk snare, diminutif polip

Jumbo Forceps Polypectomy Versus Cold Snare Polypectomy for Removal of Diminutif Colorectal Polyps

Abstract

Objective: Most polyps found during colonoscopy are diminutive (≤5 mm). Polypectomy techniques are highly variable and determined by the endoscopist's preference. The aim of this study was to compare the efficacy and safety of jumbo forceps polypectomy (JFP) and cold snare polypectomy (CSP) for the removal of diminutive polyps (DP).
Materials and Methods: Patients who underwent colonoscopy for any reason in our clinic and were found to have DP were randomized into two groups as JFP and CSP. The main outcome was complete polyp resection and complication rate.
Results: A total of 100 polypectomies (50 in each group) were analyzed. The mean age of the patients was 59.1±11.2 years. Demographic characteristics of the patients were similar between groups. The overall rate of complete resection for DPs was not significantly different between JFP and CSP groups (90% versus 82%, p=0.38). Polypectomy time was significantly longer in the CSP group for polyps ≤3 mm (p=0.008). 4% minor bleeding and 8% tissue retrieval failure were noted for polyps resected by CSP. The complication rate was significantly higher in the CSP group (p=0.01).
Conclusion: JBF and CSP are not statistically different in completely removing DPs. However, the complication rate was lower in the JFP group. 

Keywords

endoscopic polypectomy, jumbo forceps, cold snare, diminutif polyps

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