ABSTRACT
Introduction@#Colorectal cancer remains one of the critical healthcare challenges nowadays. There are a lot of studies done on colonic polypectomy around the world, and mostly diagnosis with dysplasia change, so we consider to chose to study this topic.@*Aim@#In this study, we aimed to compare the between cold snare polypectomy (CSP) and hot snare polypectomy (HSP) of removing colon polyps. This method helped us to investigate which of the two methods is most prevalent for polypectomy.@*Materials and Method@#The research was carried out using a targeted sampling method from the cases where colonoscopy was performed between 2022 and 2023, based on the Center for Imaging Diagnostics and Pathology of Third General Hospital of Mongolia with a colon polyps less than 5mm in size should be removed using the cold snare method according to the recommendation, and polyps between 5-10 mm should be removed using the hot snare method. After polypectomy, we assessed deep mucosal lesions using the Sydney classification.@*Result@#The average age of the 81 cases included in the study was 57.9 years, and the male-female ratio was 1:1.2.149 cases (75.6%) of slightly elevated type 0-IIa according to the Paris classification, according to the morphological structure revealed by endoscopy, while 79 cases (75.6%) were tubular adenoma according to histological analysis. (38.9%), low grade dysplasia 52 (25.6%) and high grade dysplasia 3 (1.5%) cases are noteworthy. Average polyp was 5-9 mm. Most of polyps removed was left side of colon especially in sigmoid colon. Bleeding rate was higher in hot snare method 11.5%. (1/149, 0.7%, 5/52, 9.6%; P = 0.6). There was no recurrent rate and no perforation in our study. @*Conclusions@#In our study, average size of 5-9 mm were removed and slightly elevated (0-IIa), sessile (0-Is) type of polyps were commonly found in the sigmoid colon. There is a higher risk of bleeding due to mucosal damage in hot snare polypectomy. A combination of hot and cold methods is equally effective for resection of colon pollyps up to 1 cm in size.
ABSTRACT
OBJECTIVE: To analyze the risk factors for incomplete endoscopic submucosal resection of rectal neuroendocrine neoplasms(r-NENs) and offer clinical experience after incomplete endoscopic submucosal resection. METHODS: From February 2012 to February2018, 62 cases of rectal carcinoid tumors resected by endoscopic submucosal dissection(ESD) were enrolled, and the factors associated with incomplete endoscopic resection were retrospectively analyzed by univariate and multivariate analysis. RESULTS: Univariate analysis demonstrated that depth of infiltration(P<0.05) and central depression of the surface mucosa(P<0.05) were risk factors for incomplete resection of ESD in rectal neuroendocrine neoplasms. Multivariate analysis revealed that central depression of the surface mucosa(P= 0.031) and infiltration of the lesion into the submucosa(P= 0.014) were independent risk factors for incomplete resection of rectal neuroendocrine neoplasms. CONCLUSION: Depth of infiltration into submucosa and the central depression of surface are associated with incomplete resection of rectal neuroendocrine neoplasm. After an incomplete ESD resection of rectal neuroendocrine neoplasm, without evidence of lympho-vascular invasion, a periodic follow-up examination may be considered.
ABSTRACT
Endoscopic resection of early gastric cancer is defined as incomplete when tumor cells are found at the resection margin upon histopathological examination. However, a tumor-positive resection margin does not always indicate residual tumor; it can also be caused by tissue contraction during fixation, by the cautery effect during endoscopic resection, or by incorrect histopathological mapping. Cases of highly suspicious residual tumor require additional endoscopic or surgical resection. For inoperable patients, argon plasma coagulation can be used as an alternative endoscopic treatment. Immediately after the incomplete resection or residual tumor has been confirmed by the pathologist, clinicians should also decide upon any additional treatment to be carried out during the follow-up period.