Treatment with argon plasma coagulation reduces recurrence after piecemeal resection of large sessile colonic polyps: A randomized trial and recommendations

摘要: Background: Recurrence is frequent after piecemeal snare resection of large sessile colorectal polyps. The aim this study was to evaluate the safety and efficacy argon plasma coagulation (APC) in preventing recurrence when applied edge base polypectomy site apparently complete resection. Methods: Patients with (>1.5 cm) polyps removed by cautery were placed into 2 groups. first consisted patients believed endoscopist be completely excised. These randomized either no further therapy (control) or APC rim any residual mucosal submucosal tissue site. second group comprised whom polyps, as judged endoscopist, incompletely excised polypectomy; routinely without randomization all visible remaining adenomatous tissue. Follow-up colonoscopy performed within 3 months 1 year; biopsy specimens taken from indicated. Results: There fewer recurrences (1/10 APC, 7/11 APC; p = 0.02). In initial incomplete polypectomy, detected at 6 13 despite APC. One patient hospitalized abdominal pain minor rectal bleeding but required intervention. other episodes significant late caused polypectomy. referred for surgery unsuccessful endoscopic management. Conclusions: apparent adenomas, postpolypectomy application reduces recurrence. (Gastrointest Endosc 2002;55:371-5.)