| The Iatrogenic Complications of Colonoscopic Polypectomy: A Multicenter Retrospective Study |
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Min Ho Choi, Yun Sun Choi, Chan Soo So, Woon Geon Shin, Kyoung Oh Kim, Hyun Joo Jang, Cheol Hee Park, Kyung Ho Kim, Jin Bae Kim, Il Hyun Baek, Kwang Ho Baik, Sea Hyub Kae, Hak Yang Kim |
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Department of Internal Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
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| 용종절제술 중 발생한 의인합병증에 대한 다기관 공동 연구 |
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최민호, 최윤선, 소찬수, 신웅건, 김경오, 장현주, 박철희, 김경호, 김진배, 백일현, 백광호, 계세협, 김학양 |
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한림대학교 의과대학 한강성심병원 내과학교실 |
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| Abstract |
Background/Aims
Colonoscopic polypectomy is an effective tool for the treatment of colonic polyps. With the recent widespread use of colonoscopic polypectomy, there is a growing concern about iatrogenic complications, such as bleeding and perforation. The aim of this study is to analyze the clinical presentation and management of complications during colonoscopic polypectomy. Methods: We retrospectively reviewed the medical records of colonoscopic examinations performed at 5 hospitals of Hallym University Medical Center between June 2005 and June 2008. Results: A total of 26,773 colonoscopies and 4,123 colonoscopic polypectomy were performed. The overall rate of complication was 1.04% (43/4,123). Perforation occurred in 0.19% (8/4,123) of cases, and bleeding occurred in 0.85% (35/4,123) of cases. Perforation occurred in 0.05% of snare polypectomies, 1.09% of endoscopic mucosal resections (EMR), and 7.14% of endoscopic submucosal dissections (ESD). Bleeding occurred in 0.8% of snare polypectomies, 1.09% of EMRs, and 3.57% of ESDs. The complication rate of ESDs was higher than in EMRs and snare polypectomies (P<0.001). Endoscopic clippings were performed in 25% of perforation and 66.7% of bleeding cases. Medical treatment was successful in 75% of perforation and 100% of bleeding cases. Conclusions: Colonoscopic polypectomy is a safe procedure for the treatment of colonic polyps, but rarely, serious complications occur. Compared to a snare polypectomy or an EMR, the complication of an ESD occurs more frequently. Endoscopic treatment and further conservative management seems to be appropriate in most cases with complication. (Intest Res 2011;13:46-51) |
| Key Words:
Polypectomy, Colonosocpy, Complication, Hemorrhage, Perforation |
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