Endoscopy 2021; 53(S 01): S169
DOI: 10.1055/s-0041-1724711
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Colorectal Post-Polypectomy Syndrome – 15-Year Experience of a Tertiary Referral Center

M Costa
1   Centro Hospitalar e Universitário de Coimbra, Gastroenterology, Coimbra, Portugal
,
D Perdigoto
1   Centro Hospitalar e Universitário de Coimbra, Gastroenterology, Coimbra, Portugal
,
L Barreto
1   Centro Hospitalar e Universitário de Coimbra, Gastroenterology, Coimbra, Portugal
,
I Cunha
1   Centro Hospitalar e Universitário de Coimbra, Gastroenterology, Coimbra, Portugal
,
E Gravito-Soares
1   Centro Hospitalar e Universitário de Coimbra, Gastroenterology, Coimbra, Portugal
,
P Amaro
1   Centro Hospitalar e Universitário de Coimbra, Gastroenterology, Coimbra, Portugal
,
P Figueiredo
1   Centro Hospitalar e Universitário de Coimbra, Gastroenterology, Coimbra, Portugal
2   Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
› Author Affiliations
 

Aims Post-polypectomy syndrome (PPS) is an uncommon complication of colonoscopic polypectomy using eletrocoagulation. It is defined as persistent abdominal pain post-intervention without free intestinal perforation. Little is known about risk factors. The aim of this study was to characterize the syndrome in a Portuguese tertiary referral center.

Methods Retrospective study that included all the patients admitted to our Gastroenterology ward due to PPS from 08/2006 to 10/2020.

Results We identified 35 patients, 21 (60 %) men, median age of 65 years. The patients were hospitalized for a median of 5 days (IQR 4) and 20 (57.1 %) developed abdominal pain within 6 hours after the procedure. At admission, 17 (48.6 %) had fever. The mean leukocyte count was 13.51±4.36 x109/L and median C-reactive protein (CRP) was 7 mg/dL (N<0.5mg/dL). All patients were discharged after clinical improvement, none needed surgery.The polypectomy was done in-hospital in 29 (82.9 %). The median lesion size was 20 mm and 32 (91.4 %) were >10 mm. Twenty-two (62.9 %) had polypoid configuration (Paris 0-Ip and 0-Is). Fifteen (42.9 %) were identified in the left colon. Submucosal injection was performed in 18(51.4 %) Paris 0-Is/II lesions and 3(8.6 %) 0-Ip lesions. Considering the histopathology, 16 (45.7 %) lesions were adenomas with low grade dysplasia and 12 (34.3 %) high grade dysplasia/carcinoma. We found no correlation between longer hospitalization and age, lesion size, time from procedure to onset of pain, leukocyte count or CRP.

Conclusions Given the hot snare colorectal resections in our department and consequent cases of PPS from 2016 to 2019, the annual incidence of PPS varied from 0.09 % to 2.1 %, respectively and increasing progressively. The present study is limited by its retrospective design and small population. This condition shows an excellent prognosis. Endoscopists should be aware of this potential complication in the evaluation of post-diathermic resection abdominal pain, which can mimic colorectal perforation.

Citation: Costa M, Perdigoto D, Barreto L et al. eP215 COLORECTAL POST-POLYPECTOMY SYNDROME – 15-YEAR EXPERIENCE OF A TERTIARY REFERRAL CENTER. Endoscopy 2021; 53: S169.



Publication History

Article published online:
19 March 2021

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