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.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

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

Contributors, Places and Time

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

Further information

• DOI: 10.1055/a-2427-1948
• URN: urn:nbn:de:101:1-2411281130053.148244083016
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 15.08.2025, 7:20 AM CEST