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KMID : 0988920130110010046
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Intestinal Research
2013 Volume.11 No. 1 p.46 ~ p.51
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The Iatrogenic Complications of Colonoscopic Polypectomy: A Multicenter Retrospective Study
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Choi Min-Ho
Choi Yun-Sun
So Chan-Soo
Shin Woon-Geon
Kim Kyoung-Oh
Jang Hyun-Joo
Park Cheol-Hee
Kim Kyung-Ho
Kim Jin-Bae
Baek Il-Hyun
Baik Kwang-Ho
Kae Sea-Hyub
Kim Hak-Yang
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Abstract
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Background/Aims: Colonoscopic polypectomy is an effective tool for the treatment of colonic polyps. With the recent widespread use of colonoscopic polypectomy, there is a growing concern about iatrogenic complications, such as bleeding and perforation. The aim of this study is to analyze the clinical presentation and management of complications during colonoscopic polypectomy.
Methods: We retrospectively reviewed the medical records of colonoscopic examinations performed at 5 hospitals of Hallym University Medical Center between June 2005 and June 2008.
Results: A total of 26,773 colonoscopies and 4,123 colonoscopic polypectomy were performed. The overall rate of complication was 1.04% (43/4,123). Perforation occurred in 0.19% (8/4,123) of cases, and bleeding occurred in 0.85% (35/4,123) of cases. Perforation occurred in 0.05% of snare polypectomies, 1.09% of endoscopic mucosal resections (EMR), and 7.14% of endoscopic submucosal dissections (ESD). Bleeding occurred in 0.8% of snare polypectomies, 1.09% of EMRs, and 3.57% of ESDs. The complication rate of ESDs was higher than in EMRs and snare polypectomies (P<0.001). Endoscopic clippings were performed in 25% of perforation and 66.7% of bleeding cases. Medical treatment was successful in 75% of perforation and 100% of bleeding cases.
Conclusions: Colonoscopic polypectomy is a safe procedure for the treatment of colonic polyps, but rarely, serious complications occur. Compared to a snare polypectomy or an EMR, the complication of an ESD occurs more frequently. Endoscopic treatment and further conservative management seems to be appropriate in most cases with complication.
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KEYWORD
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Polypectomy, Colonosocpy, Complication, Hemorrhage, Perforation
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