Complication of Colonoscopic Polypectomy / 대한소화기내시경학회지

BACKGROUND/AIMS: Colonic adenomatous polyp is known as a premalignant lesion. Colonoscopic polypectomy, using for its removal and prevention of primary colon cancer has been considered as a effective and safe method. This study was conducted to assess its complication and safety of colonoscopic polypectomy. METHODS: One thousand two hundred ninety three polypectomy were done using colonoscopic hot biopsy, snare polypectomy, endoscopic mucosal resection (EMR) and piecemeal polypectomy in 679 patients from 1983 to 1999, and postpolypectomy complications and its rate were evaluated. RESULTS: 1) Postpolypectomy bleeding occured 18 cases of 1293 polypectomies (1.4%), including 10 cases of initial bleeding and 8 cases of delayed bleeding. In 9 cases (0.7%) of them hemostatic therapy were required. In delayed bleeding most cases (75%) of them occured within 66 hours after polypectomy. 2) Postpolypectomy bleeding occured in 10 cases of 982 polypectomies (1.0%) below 0.9 cm in polyp diameter, 5 cases of 242 polypectomies (2.1%) between 1.0 cm and 1.9 cm in polyp diameter and 3 cases of 69 polypectomies (4.3%) more than 2.0cm in polyp diameter (p<0.05). 3) There were no significant correlation between postpolypectomy bleeding and polypectomy methods (p=0.06) and between postpolypectomy bleeding and gross type of polyps (p=0.40) statistically. 4) Postpolypectomy perforation occured in 1 case of 1293 polypectomies (0.1%). Estimated overall postpolypectomy complication rate including bleeding and perforation was 1.5%. CONCLUSIONS: Colonoscopic polypectomy is a relatively safe method in removing colonic polyp and its complication is related to size of polyp.

Posterior Stabilization with Halifax Interlaminar Clamps in Unstable Cervical Spine Injuries

Fifty-two patients with unstable cervical spine injuries underwent operations between January 1, 1990 to June 30, 1997 in our institution and this is retrospective study on clinical results about these patients. Patients with cervical instability resulted from injury posterior column, being included in White's criteria, were treated with Hafifax interlaminar clamps for cervical instability. We followed up forty-two cases for more than one year. All of the forty- two cervical fixations showed immediate and long term stability and there were no neurological complication. Neu rologic improvements were seen in thirty three, but thirteen cases were unchanged. These results indicate that Halifax interlaminar clamps are consider to be a safe and effective method for posterior stabilization of va rious causes of cervical spine instability.