注射肾上腺素减少体积辅助结肠巨大息肉内镜下摘除

Epinephrine volume reduction assisted endoscopic removal of giant colon polyps

背景探索结肠巨大息肉内镜下易于摘除和避免出血和穿孔并发症的方法。方法短蒂或亚蒂巨大息肉,内镜下在息肉组织及蒂部或蒂部周围组织多点注射肾上腺素生理盐水,至少5min后,再进行息肉圈套摘除。计算摘除前后息肉体积的变化。结果在息肉注射肾上腺素生理盐水后,息肉的体积较注射前减少了约72%。所有息肉均易于圈套摘除。术后未发生出血或穿孔。结论注射肾上腺素生理盐水减少息肉体积辅助进行内镜下结肠巨大息肉摘除是一种较为安全的操作。由于该操作简便,易于掌握,值得进行推广。

AIM Management of giant colon polyps（ 〉 3 cm） can be a challenge for the therapeutic endoscopist due to the potential for bleeding and the difficult technical aspects of removing giant polyps. We introduce a method named epinephrine volume reduction（EVR） which greatly facilitates assessment and removal of giant polyps through reduction of polyps volume. Methods Giant colon polyps were injected with 1：10,000 epinephrine-saline solution into polyps tissues, stalk and tissues nearby the stalk. After at least 5 minutes after injection, polypectomy was performed. Pre-EVR and post-EVR volumes of giant polyps were calculated. Results In our group, the volume of polyps was reduced about 72% so that it is feasible to evaluate and further remove polyps under colonoscopy. No bleeding and perforation were observed. Conclusions EVR assisted endoscopic removal of giant colon polyps is a safe procedure. As a simple, feasible, and practical tool, EVR is greatly recommended to endoscopists in the management of giant colon polyps.