Histological Quality of Small Polyps Resected Uoosing Different Electric Currents in a Colonoscopic Polypectomy / 대한소화기내시경학회지

BACKGROUND/AIMS: Most polyps encountered during a colonoscopic polypectomy are small. Thus, accurate evaluation of small polyp histology is important in the decision-making process. The aim of this study was to assess and compare the histological quality of polyps obtained by the use of snare polypectomy with two different electric currents. METHODS: Consecutive polyps less than 1 cm were identified and removed by use of either the blend mode (Blended mode, Circon, BC-200) or automatic cutting and coagulation mode (Endocut Q mode, effect 3, 40 watts, ERBE, VAIO-300). An experienced gastrointestinal pathologist evaluated the specimens for cautery damage, margin, architecture, presence of muscularis mucosa and general histological quality. RESULTS: Sixty-six patients (77.2% men; mean age, 60.2+/-9.2 years) underwent 109 polypectomies (53 using the blended mode and 56 using the Endocut Q mode; mean polyp diameter, 0.87+/-0.17 mm). Age, gender, location, diameter and the histology of the polyp was not different with the use of both methods. The cautery amount (> or =2) with use of the blended mode was not significantly different than with the use of the Endocut mode (50.9% vs. 39.2%, p=0.22). The cautery degree, margin, architecture, presence of muscular mucosa and overall histological quality was not different with the use of both methods. CONCLUSIONS: The histological quality of polyps less than 1 cm obtained by use of either the blended mode or Endocut Q mode was not different.

Comparison of Complication between Automatically Controlled Cut System (Endocut) and Conventional Blended Cut Current over Endoscopic Sphincterotomy / 대한소화기내시경학회지

BACKGROUND/AIMS: Endoscopic sphincterotomy (EST) is a common therapeutic technique for biliary and pancreatic diseases. However, it is associated with complications such as bleeding, pancreatitis, and perforation. Automatically controlled cut system (Endocut) is known to reduce the level of hemorrhage but lead to pancreatitis. This study examined whether or not the Endocut can reduce the rate of complications of EST compared with that of the conventional blended cut current. METHODS: From September 2005 to July 2006, 519 patients were treated with EST using either Endocut (ERBE VIO 300D, 144 patients) or the conventional blended cut current (Olympus UES-30, 375 patients). Two groups were compared retrospectively for the complications of EST. RESULTS: There were no significant differences in age, gender, and the indications for EST between the two groups. Endoscopically observed bleeding and clinically evident bleeding occurred in 6.9% (10/144), 1.4% (2/144) in the Endocut group and 8.5% (31/375), 2.2% (8/375) in the conventional blended cut current group, respectively (p=0.62 and 0.58, respectively). Clinical bleeding occurred in 2 patients in the Endocut group but it was mild and easily controlled by endoscopic treatment. Mild, moderate, and severe clinical bleeding occurred in 3, 4, and 1 patient in the blended group, respectively. Pancreatitis was encountered in 6.0% (8/134) of the Endocut group and in 5.7% (21/352) of the blended group (p=0.83). Perforation only occurred in 2 patients in the blended group. CONCLUSIONS: There were a similar number of complications from EST in the Endocut and conventional blended cut current groups.