Published online Dec 21, 2017. doi: 10.3748/wjg.v23.i47.8405
Peer-review started: September 3, 2017
First decision: September 20, 2017
Revised: October 3, 2017
Accepted: October 26, 2017
Article in press: October 26, 2017
Published online: December 21, 2017
To evaluate the rate of adverse events (AEs) during consecutive gastric and duodenal polypectomies in several Spanish centers.
Polypectomies of protruded gastric or duodenal polyps ≥ 5 mm using hot snare were prospectively included. Prophylactic measures of hemorrhage were allowed in predefined cases. AEs were defined and graded according to the lexicon recommended by the American Society for Gastrointestinal Endoscopy. Patients were followed for 48 h, one week and 1 mo after the procedure.
308 patients were included and a single polypectomy was performed in 205. Only 36 (11.7%) were on prior anticoagulant therapy. Mean polyp size was 15 ± 8.9 mm (5-60) and in 294 cases (95.4%) were located in the stomach. Hemorrhage prophylaxis was performed in 219 (71.1%) patients. Nine patients presented AEs (2.9%), and 6 of them were bleeding (n = 6, 1.9%) (in 5 out of 6 AE, different types of endoscopic treatment were performed). Other 24 hemorrhagic episodes could be managed without any change in the outcome of the endoscopy and, consequently, were considered incidents. We did not find any independent risk factor of bleeding.
Gastroduodenal polypectomy using prophylactic measures has a rate of AEs small enough to consider this procedure a safe and effective method for polyp resection independently of the polyp size and location.
Core tip: The safety of polypectomy in the upper gastroduodenal tract is controversial because the reported rate in retrospective studies is higher than in colonic polypectomy but results come mainly from retrospective studies and they do not use the same standardized nomenclature and definitions for adverse events. To our knowledge, this is the first study using the ASGE lexicon for reporting adverse events of gastro-duodenal polypectomy and shows an acceptable low rate, confirming the safety of this procedure.