Endoscopy 2020; 52(S 01): S171
DOI: 10.1055/s-0040-1704527
ESGE Days 2020 ePoster Podium presentations
Friday, April 24, 2020 11:00 – 11:30 Advanced imaging in colon ePoster Podium 5
© Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC ANALYSIS OF MICROSTRUCTURES OF THE COLON MUCOSA ON THE EDGE OF THE POST-RESECTION DEFECT AS A MEASURE OF PREVENTING RECURRENCE OF POLYPS AFTER POLYPECTOMY

N Ageykina
1   Medsi Clinic, Moscow, Russian Federation
,
E Fedorov
2   Lomonosov Moscow State University, Moscow, Russian Federation
3   Pirogov Russian National Research Medical University, Moscow, Russian Federation
,
N Oleynikova
2   Lomonosov Moscow State University, Moscow, Russian Federation
,
P Malkov
2   Lomonosov Moscow State University, Moscow, Russian Federation
,
N Danilova
2   Lomonosov Moscow State University, Moscow, Russian Federation
,
O Kharlova
2   Lomonosov Moscow State University, Moscow, Russian Federation
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims To assess the usefulness of cold polypectomy of small colon polyps on the basis of endoscopic microstructural analysis of the edges of the post-resection defect.

Methods In 74 patients 103 colon polyps were detected. These were up to 10 mm in size, without signs of severe dysplasia or cancer. Most of the polyps (81/103;78.7%) were of flat-elevated and were of polypoid 21/103;20.3%. The polyps were resected with a cold snare. A complete endoscopic analysis of the microstructures and the capillary vessels of the mucosa was performed on the edge of the post-resection defect.

Results The criteria followed post cold polypectomy in order to check its success were: endoscopic visualization on the edge of the post-resection defect of 1)parallel crypts and 2)the pit pattern of type I (S.Kudo). This was observed in 93(90.3%) cases. In 10(9.7%) cases, single extended modified crypts were found, with violation of their parallelism, which was a sign of residual tissue. A combined removal technique was used – a cold snare, supplemented with biopsy forceps for the purpose of radical intervention. We noted differences in the location of the crypts of the rectum. In this area, the loss of parallelism of the crypt is determined; the irregularity of the structure giving the impression of “falling crypts”. An endoscopic assessment of the capillary network of the colon mucosa was performed. Flat-elevated polyps have capillary vessels that are small in diameter, which significantly reduces the risk of bleeding. Follow-up colonoscopies were performed on 11(10.7%) patients: no recurrence of polyps were detected.

Conclusions An assessment of the edges of the post-resection defect of the mucosa after cold polypectomy provides a reliable diagnosis of the complete success of the endoscopic intervention and the possibility of removing residual tumor tissue (if present) immediately after its completion, and therefore reduces the number of recurrence of tumors.