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rate of adverse events of gastroduodenal snare polypectomy for non-flat polyp is low: A prospective and multicenter study

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World Journal of Gastroenterology 2017年第47期23卷 8405-8414页

作者： Henry Córdova Lidia Argüello Carme Loras Antonio Naranjo Rodríguez Faust Riu Pons Joan B Gornals David Nicolás-Pérez Xavier Andújar Murcia Luis Hernández Santos Santolaria Carles Leal Carles Pons Enrique Pérez-Cuadrado-Robles Orlando García-Bosch Michel Papo Berger José Luis Ulla Rocha Cristina Sánchez-Montes Gloria Fernández-Esparrach Endoscopy Unit.Institut de Malalties Digestives Hospital ClínicIDIBAPSCIBERehdUniversitat de Barcelona Digestive Endoscopy Unit Digestive Diseases DepartmentGastrointestinal Endoscopy Research GroupIISLa Fe Polytechnic University Hospital Hospital Universitari Mútua de Terrassa CIBERehd Hospital Reina Sofía Hospital Del Mar Hospital Universitari de Bellvitge IDIBELLUniversitat de BarcelonaHospitalet de Llobregat Hospital Universitario de Canarias Hospital Santos Reyes Aranda de Duero Hospital San Jorge Consorci Hospitalari de Vic Universitat de Vic Hospital de Viladecans Hospital Morales Meseguer Hospital Moisès Broggi Sant Joan Despí Hospital Joan XXIII Complejo Hospitalario de Pontevedra

AIM To evaluate the rate of adverse events(AEs) during consecutive gastric and duodenal polypectomies in several Spanish centers. METHODS Polypectomies of protruded gastric or duodenal polyps ≥ 5 mm using hot snare were prospectively included. Prophylactic measures of hemorrhage were allowed in predefined cases. AEs were defined and graded according to the lexicon recommended by the American Society for Gastrointestinal Endoscopy. Patients were followed for 48 h, one week and 1 mo after theprocedure. RESULTS308 patients were included and a single polypectomy was performed in 205. Only 36(11.7%) were on prior anticoagulant therapy. Mean polyp size was 15 ± 8.9 mm(5-60) and in 294 cases(95.4%) were located in the stomach. Hemorrhage prophylaxis was performed in 219(71.1%) patients. Nine patients presented AEs(2.9%), and 6 of them were bleeding(n = 6, 1.9%)(in 5 out of 6 AE, different types of endoscopic treatment were performed). Other 24 hemorrhagic episodes could be managed without any change in the outcome of the endoscopy and, consequently, were considered incidents. We did not find any independent risk factor of bleeding.CONCLUSION Gastroduodenal polypectomy using prophylactic measures has a rate of AEs small enough to consider this procedure a safe and effective method for polyp resection independently of the polyp size and location.

关键词： Polypectomy Bleeding Adverse events protruded polyps Gastroduodenal Foregut

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