PREDICTIVE FACTORS OF FAILURE AND COMPLICATIONS OF ENDOSCOPIC COLONIC POLYPECTOMY: A SINGLE-CENTER STUDY

Aims:

Endoscopic polypectomy is a simple and effective technique which can sometimes lead to serious complications that may require surgery.

The purpose of this study is to describe the incidence of colonic polyps, the predictive factors of failure of polypectomy and its complications.

Methods:

Retrospective, descriptive and analytic study involving all patients with colonic polyps who had endoscopic polypectomy in our digestive endoscopy unit between January 2016 and July 2017.

Results:

A total of 1368 colonoscopies were included. They objectified 660 colonic polyps in 338 patients (24.7%) with a mean age of 56.4 years (31 – 90). Indications of colonoscopy were essentially: Constipation (16.8%), screening colonoscopy (15.3%) and abdominal pain (13.7%). The most frequent site of polyps was sigmoid in 28.2% of cases. Average size of polyps was 6.84 mm. Polyps with a size greater than or equal to 10 mm accounted for 17.8% of the total. Polyps were sessile in 97.8% of cases. Sixty-nine percent of the polyps were adenomas and 67% of them had low grade dysplasia. Six hundred and sixty polypectomies were made: 236 polyps (35.7%) were resected by diathermic loop and 424 (64.3%) by cold forceps polypectomy. Polyp Resection was not monobloc in 5.6% of cases. A post-polypectomy hemorrhage was noted in 6 patients (1.77%). No colonic perforation was noted. Resection of polyps was not complete in 7.6% of cases during endoscopic control. The independent predictive factor of post polypectomy hemorrhage was a polyp size > 15 mm (p = 0.012). The two independent predictors of incomplete resection were right colonic localization of the polyp and size greater than 12 mm (p = 0.04).

Conclusions:

In our study, the two predictive factors associated with difficult polypectomy were polyp size (> 12 mm) and right colonic localization of polyps.