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Snaring large serrated polyps

机译：诱捕大型锯齿状息肉

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Background: Serrated polyps of the large bowel are potentially premalignant, difficult to see, but important to remove. Few studies describe the technique or outcomes of serrated polypectomy. We sought to present outcomes of a series of polypectomies of large serrated polyps in comparison to a series of endoscopic resections of large adenomas. Methods: This retrospective, comparative, single endoscopist study was performed in an outpatient colonoscopy department of a tertiary referral medical center. Patients had outpatient colonoscopy where a large (≥2 cm) serrated polyp or adenoma was removed. Outcomes were completeness of excision and complications of polypectomy. A database of endoscopic polypectomies was reviewed. Polypectomy of large serrated polyps was compared with polypectomy of large adenomas. Results: There were 132 large serrated polyps in 112 patients and 563 adenomas in 428 patients. More serrated polyps were right sided (120 of 130, 92.3 %, vs. 379 of 563, 67 %) (p < 0.0001). The serrated polyps were smaller than the adenomas (mean 25.5 ± 7.9 mm standard deviation) versus 36.8 ± 16.9 mm standard deviation (p < 0.001). There were four complications of serrated polypectomy in four patients (4 % of polyps, 5 % of patients): three postpolypectomy bleeds and one postpolypectomy syndrome. There were 33 complications of adenoma removal (31 postpolypectomy bleeding and two postpolypectomy syndrome) (6.9 % of polyps, p = 0.376, 8.4 % of patients, p = 0.371). On follow-up, 36 of 51 patients (71 %) with serrated polyps had metachronous lesions compared to 133 of 298 patients (45 %) with adenomas (p < 0.0001). There were fewer residual polyps in the serrated group (4 of 47 vs. 64 of 298, p = 0.001). Conclusions: Removal of large serrated colorectal polyps is no more complicated than polypectomy of similarly sized adenomas. However, large serrated polyps have a higher rate of metachronous polyps than similarly sized adenomas and surveillance should be adapted to reflect these findings.
机译：背景：大肠的锯齿状息肉可能是恶性的，很难看到，但很重要。很少有研究描述锯齿状息肉切除术的技术或结果。我们试图介绍一系列大锯齿状息肉的多角膜切除术与一系列内镜大腺瘤切除术相比的结果。方法：这项回顾性，比较性，单一内镜医师研究是在三级转诊医疗中心的门诊结肠镜检查部门进行的。患者进行了门诊结肠镜检查，其中切除了大的（≥2 cm）锯齿状息肉或腺瘤。结果是切除的完整性和息肉切除术的并发症。审查了内窥镜检查的数据库。将大锯齿状息肉的息肉切除术与大腺瘤的息肉切除术进行了比较。结果：112例患者有132例大锯齿状息肉，428例患者有563例腺瘤。右侧的锯齿状息肉更多（130个中的120个，占92.3％，而563个中的379个，占67％）（p <0.0001）。锯齿状息肉小于腺瘤（标准差为25.5±7.9毫米），而标准差为36.8±16.9毫米（p <0.001）。锯齿状息肉切除术有4例并发症（4例息肉，5％的患者）：3例息肉切除术后出血和1例息肉切除术后综合征。共有33例腺瘤切除并发症（息肉切除术后出血31例，息肉切除术后综合征2例）（息肉6.9％，p = 0.376，患者8.4％，p = 0.371）。随访时，51例锯齿状息肉患者中有36例（71％）有异时病变，而298例腺瘤患者中有133例（45％）有异位病变（p <0.0001）。锯齿状组的残留息肉较少（47例中的4例与298例中的64例，p = 0.001）。结论：去除大的锯齿状结肠直肠息肉并不比类似大小的腺瘤息肉切除术复杂。但是，大的锯齿状息肉比同等大小的腺瘤具有更高的异时性息肉，应该进行监测以反映这些发现。

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