Clin Endosc.  2015 Mar;48(2):136-141. 10.5946/ce.2015.48.2.136.

Use of a Double-Channel Gastroscope Reduces Procedural Time in Large Left-Sided Colonic Endoscopic Mucosal Resections

Affiliations
  • 1Department of Gastroenterology, Benizelion General Hospital, Heraklion, Greece. gpaspatis@gmail.com
  • 2Department of Social Medicine, University of Crete, Heraklion, Greece.

Abstract

BACKGROUND/AIMS
Endoscopic mucosal resection (EMR) of large colorectal lesions is associated with increased procedural time. The objective of this study was to evaluate the effect of double-channel gastroscope (DCG) use on the procedural time of EMRs in the rectosigmoid area.
METHODS
All EMRs for sessile or flat rectosigmoid lesions > or =2 cm performed between July 2011 and September 2012 were retrospectively analyzed.
RESULTS
There were 55 lesions > or =2 cm in the rectosigmoid area in 55 patients, of which 26 were removed by EMR using a DCG (DC group) and 29 by using an ordinary colonoscope or gastroscope (OS group). The mean size of the removed polyps, morphology, adverse effects, and other parameters were similar between the two groups. The mean procedural time was significantly lower in the DC group than in the OS group (24.4+/-18.3 minutes vs. 36.3+/-24.4 minutes, p=0.015). Moreover, in a subgroup of patients with polyps >40 mm, the statistical difference in the mean procedural time between the DC and OS groups was even more pronounced (33+/-21 minutes vs. 58.7+/-20.6 minutes, p=0.004).
CONCLUSIONS
Our data suggest that the use of a DCG in the resection of large nonpedunculated rectosigmoid lesions significantly reduces the procedural time.

Keyword

Endoscopic mucosal resection; Double-channel gastroscope; Polypectomy; Colonoscopy

MeSH Terms

Colon*
Colonoscopes
Colonoscopy
Gastroscopes*
Humans
Polyps
Retrospective Studies

Figure

  • Fig. 1 Polyp size and mean procedural time. DCG, double channel gastroscope; OS, ordinary gastroscope or colonoscope.

  • Fig. 2 Clinical management of the patients. EMR, endoscopic mucosal resection; DCG, double channel gastroscope; OS, ordinary gastroscope or colonoscope; TEMS, transanal endoscopic microsurgery.


Cited by  1 articles

Is the Double Channel Gastroscope Useful in Endoscopic Mucosal Resection for Large Sessile Colon Polyps?
Kwang An Kwon
Clin Endosc. 2015;48(2):89-90.    doi: 10.5946/ce.2015.48.2.89.


Reference

1. Winawer SJ, Zauber AG, Ho MN, et al. The National Polyp Study Workgroup. Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med. 1993; 329:1977–1981. PMID: 8247072.
Article
2. Zauber AG, Winawer SJ, O'Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012; 366:687–696. PMID: 22356322.
Article
3. Rex DK. Have we defined best colonoscopic polypectomy practice in the United States? Clin Gastroenterol Hepatol. 2007; 5:674–677. PMID: 17544994.
Article
4. Endoscopic Classification Review Group. Update on the paris classification of superficial neoplastic lesions in the digestive tract. Endoscopy. 2005; 37:570–578. PMID: 15933932.
5. Rosenberg N. Submucosal saline wheal as safety factor in fulguration or rectal and sigmoidal polypi. AMA Arch Surg. 1955; 70:120–122. PMID: 13217613.
6. Deyhle P, Jenny S, Fumagalli I. Endoscopic polypectomy in the proximal colon. A diagnostic, therapeutic (and preventive?) intervention. Dtsch Med Wochenschr. 1973; 98:219–220. PMID: 4684531.
7. Seewald S, Soehendra N. Perforation: part and parcel of endoscopic resection? Gastrointest Endosc. 2006; 63:602–605. PMID: 16564859.
Article
8. Tanaka S, Haruma K, Oka S, et al. Clinicopathologic features and endoscopic treatment of superficially spreading colorectal neoplasms larger than 20 mm. Gastrointest Endosc. 2001; 54:62–66. PMID: 11427843.
Article
9. Ferrara F, Luigiano C, Ghersi S, et al. Efficacy, safety and outcomes of 'inject and cut' endoscopic mucosal resection for large sessile and flat colorectal polyps. Digestion. 2010; 82:213–220. PMID: 20588036.
Article
10. The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc. 2003; 58(6 Suppl):S3–S43. PMID: 14652541.
11. Rex DK. Review article: moderate sedation for endoscopy: sedation regimens for non-anaesthesiologists. Aliment Pharmacol Ther. 2006; 24:163–171. PMID: 16842446.
Article
12. Brooker JC, Saunders BP, Shah SG, Thapar CJ, Suzuki N, Williams CB. Treatment with argon plasma coagulation reduces recurrence after piecemeal resection of large sessile colonic polyps: a randomized trial and recommendations. Gastrointest Endosc. 2002; 55:371–375. PMID: 11868011.
Article
13. Tsiamoulos ZP, Bourikas LA, Saunders BP. Endoscopic mucosal ablation: a new argon plasma coagulation/injection technique to assist complete resection of recurrent, fibrotic colon polyps (with video). Gastrointest Endosc. 2012; 75:400–404. PMID: 22154411.
Article
14. Cotton PB, Eisen GM, Aabakken L, et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc. 2010; 71:446–454. PMID: 20189503.
Article
15. Buchner AM, Guarner-Argente C, Ginsberg GG. Outcomes of EMR of defiant colorectal lesions directed to an endoscopy referral center. Gastrointest Endosc. 2012; 76:255–263. PMID: 22657404.
Article
16. Konishi F, Morson BC. Pathology of colorectal adenomas: a colonoscopic survey. J Clin Pathol. 1982; 35:830–841. PMID: 7107955.
Article
17. Arebi N, Swain D, Suzuki N, Fraser C, Price A, Saunders BP. Endoscopic mucosal resection of 161 cases of large sessile or flat colorectal polyps. Scand J Gastroenterol. 2007; 42:859–866. PMID: 17558911.
Article
18. Bergmann U, Beger HG. Endoscopic mucosal resection for advanced non-polypoid colorectal adenoma and early stage carcinoma. Surg Endosc. 2003; 17:475–479. PMID: 12415335.
Article
19. Bories E, Pesenti C, Monges G, et al. Endoscopic mucosal resection for advanced sessile adenoma and early-stage colorectal carcinoma. Endoscopy. 2006; 38:231–235. PMID: 16528648.
Article
20. Mahadeva S, Rembacken BJ. Standard "inject and cut" endoscopic mucosal resection technique is practical and effective in the management of superficial colorectal neoplasms. Surg Endosc. 2009; 23:417–422. PMID: 18806938.
Article
21. Su MY, Hsu CM, Ho YP, et al. Endoscopic mucosal resection for colonic non-polypoid neoplasms. Am J Gastroenterol. 2005; 100:2174–2179. PMID: 16181365.
Article
22. Cipolletta L, Rotondano G, Bianco MA, et al. Endoscopic resection for superficial colorectal neoplasia in Italy: a prospective multicentre study. Dig Liver Dis. 2014; 46:146–151. PMID: 24183949.
Article
23. Kaltenbach T, Soetikno R. Endoscopic mucosal resection of non-polypoid colorectal neoplasm. Gastrointest Endosc Clin N Am. 2010; 20:503–514. PMID: 20656248.
Article
Full Text Links
  • CE
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr