ENDOSCOPIC SUBMUCOSAL DISSECTION OF COLORECTAL PEDUNCULATED POLYPS

Background: For pedunculated colon polyps, en bloc resection with inclusion of the polyp stalk is necessary to yield an accurate histologic staging. This can be challenging in cases of large polyp and/or broad stalk using conventional snare resection. We evaluated the feasibility of Endoscopic submucosal dissection (ESD) for large pedunculated polyps with broad stalks. Methods: Between 02-2019 and 11-2021 all patients with large pedunculated polyps defined as polyp diameter ≥ 20 mm and or a broad stalk >5mm were enrolled in the study. All polyps were resected in ESD technique with dissection of the polyp stalk at the base after injection. Results: 25 patients (male=18, age mean:67 years) were included. En bloc resection was achieved in 100% (25/25 of polyps) of the patients. Polyps were mainly located in the sigmoid (n=19), rectum (n=3).Median size of polyps was 30*25*17 mm Histologic examination revealed the following results: Adenoma Low-Grade Intraepithelial Neoplasia (LG-IEN): 9; High-Grade Intraepithelial Neoplasia (HG-IEN): 7, pTis: 3, Adenoarcinoma: 5 (G1, pT1, L0, V0, Haggitt 3: 2/G2, pT1, L0, V0, Haggitt 3:2/G3, pT1, Bd3, V1, Haggitt 4: 1); Other:1. R0 resection rate was 100% and the curative resection rate yielded 96% (24/25) without severe adverse events. Conclusions: ESD achieved a high en bloc and R0 resection rate of large pedunculated polyps. In our collective, up to 32% of polyps already had adenocarcinoma resulting in a high curative resection rate due to complete resection and subsequently accurate risk classification.

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
ENDOSCOPIC SUBMUCOSAL DISSECTION OF COLORECTAL PEDUNCULATED POLYPS ; day:30 ; month:09 ; year:2024
Endoscopy International Open ; (30.09.2024)

Beteiligte Personen und Organisationen
Jakobs, Johanna Katharina
Zumblick, Malte
von Gerlach, Susanne
Stathopoulos, Petros
Glas, Sebastian
Denkert, Carsten
Denzer, Ulrike Walburga

DOI
10.1055/a-2427-1948
URN
urn:nbn:de:101:1-2411281130053.148244083016
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
15.08.2025, 07:20 MESZ

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Beteiligte

  • Jakobs, Johanna Katharina
  • Zumblick, Malte
  • von Gerlach, Susanne
  • Stathopoulos, Petros
  • Glas, Sebastian
  • Denkert, Carsten
  • Denzer, Ulrike Walburga

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