Theme |
Update on Management of Colorectal Polyp |
Title |
The Clinical Practice of Endoscopic Colorectal Polypectomy at a Clinic without Hospitalization Facilities -- Endoscopic Treatment of Colorectal Polyp at the Clinic without Hospitalization Facilities |
Author |
Osamu Toyoshima |
Gastroenterology, Toyoshima Endoscopy Clinic |
Author |
Toshihiro Nishizawa |
Gastroenterology, Toyoshima Endoscopy Clinic / Department of Gastroenterology and Hepatology, International University of Health and Welfare, Mita Hospital |
Author |
Kosuke Sakitani |
Gastroenterology, Toyoshima Endoscopy Clinic / Gastroenterology, Sakitani Endoscopy Clinic |
Author |
Yoshiyuki Takahashi |
Gastroenterology, Toyoshima Endoscopy Clinic |
Author |
Shuntaro Yoshida |
Gastroenterology, Toyoshima Endoscopy Clinic / Department of Gastroenterology, The University of Tokyo |
[ Summary ] |
Removal of colorectal adenoma reduces colorectal cancer mortality. In our clinic, we aim to improve the quality of colonoscopies, by performing pancolonic chromoendoscopy, by raising the awareness of endoscopists of the adenoma and sessile serrated polyp detection rates, and by conducting appropriate sedation. All adenomas and sessile serrated polyps detected in colonoscopy are removed. Our clinic, which does not provide hospitalization, defines the criteria and selects the procedure for polypectomy based on patients' characteristics and the features of the polyp (diameter and morphology). The criteria for polypectomy are as follows: the number of polyps is up to 10, maximum diameter of one polyp is 15 mm, and the cumulative diameter of the polyps is up to 30 mm. Recently, we actively selected cold polypectomy to avoid post‒polypectomy bleeding. Post‒polypectomy bleeding and sedation‒related hypoxemia and nausea are critical adverse events in clinical practice. In response to adverse events, informed consent and collaboration with hospital facilities are crucial. |