Retrospective Study
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2014; 6(10): 493-498
Published online Oct 16, 2014. doi: 10.4253/wjge.v6.i10.493
What can be the criteria of outpatient-based endoscopic resection for colon polyp?
Hyung Hun Kim, Sung Eun Kim, Eun Joo Cho
Hyung Hun Kim, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 137-701, South Korea
Hyung Hun Kim, Sung Eun Kim, Eun Joo Cho, Department of Internal Medicine, Kosin University, College of Medicine, Busan 602-702, South Korea
Author contributions: Kim HH designed the study, performed statistical analysis, and wrote the paper; Kim SE reviewed statistical analysis and discussion; Cho EJ established the documentation for the study.
Supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning, No. NRF-2013R1A1A1009682
Correspondence to: Hyung Hun Kim, MD, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seocho-gu, Seoul-si 137-701, South Korea. drhhkim@gmail.com
Telephone: +82-2-22586065 Fax: +82-2-22582089
Received: June 25, 2014
Revised: July 21, 2014
Accepted: September 4, 2014
Published online: October 16, 2014
Abstract

AIM: To investigate whether out-patient based endoscopic mucosal resection (EMR) for colon polyps ≤ 10 mm is safe.

METHODS: Between January 2004 and December 2012, a total of 3015 EMR cases conducted in 1320 patients were retrospectively reviewed. The factors contributing delayed hemorrhage were analyzed. We calculated the probability of delayed bleeding after stratifying conditions of specific risk factors.

RESULTS: The size of the polyp (95%CI: 1.096-1.164, P < 0.001) and patients with chronic renal failure (95%CI: 1.856-45.106, P = 0.007) were identified as independent risk factors for delayed bleeding in multivariate analysis. 95%CI for percent of delayed bleeding according to polyp size was determined for the following conditions: size ≤ 10 mm, 0.05%-0.43%; 20 mm ≥ size > 10 mm, 0.54%-2.08%; size > 20 mm, 4.22%-11.41%. 95%CI was determined for the risk of serious immediate bleeding for a polyp ≤ 10 mm was 0.10%-0.56%. Finally, 95%CI for percent of incomplete resection was 0.07%-0.49% in polyps ≤ 10 mm.

CONCLUSION: It seems acceptable to perform outpatient-based EMR for colon polyps ≤ 10 mm.

Keywords: Colon, Polyp, Endoscopic mucosal resection, Bleeding

Core tip: There has been a belief that it is safe to perform outpatient-based endoscopic mucosal resection (EMR) for a colon polyp ≤ 10 mm. We found out that the risk of delayed bleeding was 0.05% to 0.43% and that the risk of serious immediate bleeding was 0.10% to 0.56% in polyps ≤ 10 mm. From these results, we induced the conclusion that outpatient-based EMR for polyps no more than 10 mm can be performed without serious concern.