| Theme |
To prevent from complication in colonoscopy |
| Title |
Prevention and management of bleeding associated with colonic polypectomy and endoscopic mucosal resection |
| Author |
Toshihiro Kusaka |
Department of Gastroenterology, JR Sendai Hospital |
| Author |
Naoto Miyake |
Department of Gastroenterology, JR Sendai Hospital |
| Author |
Masao Ando |
Department of Gastroenterology, JR Sendai Hospital |
| Author |
Toshiyuki Mishima |
Department of Gastroenterology, JR Sendai Hospital |
| Author |
Akimichi Chonan |
Department of Gastroenterology, JR Sendai Hospital |
| Author |
Fukuji Mochizuki |
Department of Gastroenterology, JR Sendai Hospital |
| [ Summary ] |
The main complications associated with colonic polypectomy and endoscopic mucosal resection are bleeding and perforation. To prevent these complications, we must appropriately evaluate whether or not endoscopic resection is indicated and if a favorable environment, appropriate techniques for resection, and sufficient rest after resection is available. Most complications can be avoided by strict adherence to these principles. To prevent bleeding, a detachable snare is usefull for polypectomy of large pedunclated polyps and local injections are usefull for endoscopic mucosal resection of sesseile lesions. Clipping is usefull to stop bleeding endoscopically. Electric coagulation and local injection of hypertonic saline with epinephrine (HSE) may be usefull too. We must sufficiently understand the theories and techniques of endoscopic resection to properly select patients as candidates for these procedures. |