Endoscopy 2013; 45(12): 1024-1029
DOI: 10.1055/s-0033-1344394
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Complete biopsy resection of diminutive polyps

Yoon Suk Jung
1  Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
,
Jung Ho Park
1  Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
,
Hong Joo Kim
1  Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
,
Yong Kyun Cho
1  Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
,
Chong Il Sohn
1  Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
,
Woo Kyu Jeon
1  Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
,
Byung Ik Kim
1  Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
,
Jin Hee Sohn
2  Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
,
Dong Il Park
1  Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
› Author Affiliations
Further Information

Publication History

submitted 28 December 2012

accepted after revision 14 May 2013

Publication Date:
06 August 2013 (online)

Background and study aims: Cold biopsy forceps polypectomy (CBP) is commonly used for the removal of diminutive polyps; however, evidence for the efficacy of CBP is lacking. The aim of this study was to evaluate the adequacy of resection of diminutive polyps and to identify predictors for complete resection using CBP.

Patients and methods: This was a prospective study from a tertiary referral hospital in Korea. A total of 196 patients were screened, and 65 patients with diminutive polyps were enrolled. CBP was used to resect diminutive polyps until no polyp was visible by chromoendoscopy using indigo carmine spray. Each polyp base was then resected using endoscopic mucosal resection (EMR) with a 1 – 3-mm free margin. CBP and EMR specimens were sent to the histopathology department for the evaluation of the completeness of the resection. Cross sections of the EMR specimens made at 1-mm intervals were examined by a pathologist.

Results: A total of 86 diminutive polyps were available for assessment. Overall, 90.7 % (78/86) of the diminutive polyps were completely resected using CBP (95%CI 84.6 – 96.8 %). The complete resection rate for all diminutive adenomas was 92.3 % (60/65; 95%CI 85.8 – 98.8 %) and for 1 – 3-mm adenomas 100 % (95%CI 81.5 – 100 %). Polyp size, histology, and location, and number of biopsies were not different between the complete and incomplete resection groups.

Conclusions: In this small study approximately 90 % of all diminutive polyps and 100 % of 1 – 3-mm adenomatous polyps were completely resected using CBP and chromoendoscopy. CBP appears to be adequate for the resection of the majority of diminutive polyps, especially small sized adenomas (≤ 3 mm) if no residual tissue is visible by chromoendoscopy.