Journal Article

Prophylactic submucosal saline–adrenaline injection in colonoscopic polypectomy: Prospective randomized study

Hać, S., Dymecki, D., Dobosz, M., Dobrowolski, S., Babicki, A.

2004

Overview

Endoscopic polypectomy is a standard method of treatment of gastrointestinal polyps, but is associated with substantial risk of complications. The most common is hemorrhage, the rate of which varied between 0.3%, and 6%. Various prophylactic techniques have been used to reduce this incidence. The aim of this study was to establish whether the prophylactic injection of adrenaline-saline solution reduces the risk of postpolypectomy bleeding in colonoscopic polypectomy. Between May 2000 and June 2002, patients with colorectal polyps of size > or =1 cm were randomized to receive submucosal epinephrine injection (group A) or no injection (group B). The polypectomies were carried out using the conventional method. In group A, epinephrine (1/10,000) was injected into the stalk or base of the polyp. The patients were observed for complications. A total of 69 patients with 100 polyps were enrolled in this study: n = 50 in group A, and n = 50 in group B, according to randomization. There were a total of nine episodes of postpolypectomy hemorrhage, one in the epinephrine group and eight in the control group (1/50 vs 8/50, p < 0.05). The bleeding correlated with the size of the polyps and the diameter of the stalks. Epinephrine injection prior to colonoscopic polypectomy is effective in preventing bleeding.

• Publisher: Springer,Springer Nature B.V
• Subject: Adenocarcinoma - blood supply / Adenocarcinoma - surgery / Adenomatous Polyps - blood supply / Adenomatous Polyps - surgery / Aged / Biological and medical sciences / Blood Loss, Surgical / Blood Transfusion / Colonic Neoplasms - blood supply / Colonic Neoplasms - surgery / Colonic Polyps - surgery / Colonoscopy - methods / Digestive system. Abdomen / Electrocoagulation / Endoscopy / Epinephrine - administration & dosage / Epinephrine - therapeutic use / Female / General aspects / Hemostatics - administration & dosage / Hemostatics - therapeutic use / Humans / Injections, Intralesional / Investigative techniques, diagnostic techniques (general aspects) / Male / Medical sciences / Middle Aged / Postoperative Hemorrhage - etiology / Postoperative Hemorrhage - prevention & control / Premedication / Prospective Studies / Rectal Neoplasms - blood supply / Rectal Neoplasms - surgery / Sodium Chloride - administration & dosage / Sodium Chloride - therapeutic use