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- Title
Safer Colonoscopic Polypectomy with Local Submucosal Injection of Hypertonic Saline-Epinephrine Solution.
- Authors
Shirai, M.; Nakamura, T.; Matsuura, A.; Ito, Y.; Kobayashi, S.
- Abstract
Background: In view of the popular acceptance of the adenoma-carcinoma sequence, endoscopic polypectomy is indicated for the removal of colorectal adenomas. Larger or sessile lesions should be removed by an experienced endoseopist, but complications such as hemorrhage and perforation still may occur. Methods: To render the removal of sessile lesions feasible by endoscopic polypectomy and to reduce the risk of complications, we attempted local submucosal injection of bypertonic saline-epinephrine solution [(HSE) a mixture of 4.7% sodium chloride and 0.005% epinephrine] before electrosurgical snare excision; 0.5-2 ml HSE were injected into the base and immediate vicinity of polyps to produce mucosal bulging. Results: Between August 1990 and April 1992, 645 polyps in 403 patients were removed by this method; sessile lesions could be more readily removed. Of these, 17 (2.6%) revealed invasive carcinoma and 19 (3.0%) carcinoma <em>in situ</em>. The largest sessile polyp removed was 40 mm in diameter and 7 mm in height and contained a carcinoma <em>in situ</em>. Even a 6-mm depressed adenoma and two rectal carcinoid tumors could be excised completely. No serious complications were encountered with this method. Conclusion: We conclude that local injection of HSE makes the endoscopic removal of colorectal polyps much easier and safer.
- Publication
American Journal of Gastroenterology (Springer Nature), 1994, Vol 89, Issue 3, p334
- ISSN
0002-9270
- Publication type
Academic Journal