| Objective:To understand the clinical features of colonic polyps, investigate the security and effectiveness of the endoscopic treatment with colonic polyps, and the role of pretreatment in endoscopic treatment with large and huge polyps, by analyzing patient's gender and age, the characteristic of colonic polyp, such as size, location, shape, pathological type and canceration rate, the effective removal rate and incidence of complications duiring the endoscopic treatment with colonic polyps.Methods:Retrospective analysis the patients which with colonic polyps, and accepted endoscopic resection in the First Affiliated Hospital of Dalian Medical University during January 2005 and December 2009.There are 382 patients in our studying.1097 polyps we checked in 382 cases, were divided into three groups, according to size, that is:small polyp group (diameter＜1.0cm), large polyp group (1.0cm-2.0cm) and huge polyp group (diameter＞2.0cm).1093 polyps were excised. According removal methods, large polyp group and huge polyp group were divided into non-pretreatment group (adopt method A) and the pretreatment group (adopt method B).Method A is simple high-frequency electric resection, method B is using submucosal injection of adrenaline solution(0.5:10000),metal titanic clips or the first two combined before high-frequency electric resection. Small polyp group were all excised with method A. There are 53 large polyps removed with method A, 161 with method B. In huge polyp group, there are 4 with method A,37 with the method B. Among the three groups, whether there are differences in patient's gender and age, or in the characteristic of colonic polyp, the effective removal rate and incidence of complications in the endoscopic treatment of colonic polyps. Compare the effects between the two methods. Results:1.Compared with small polyp group, large polyp group and huge polyp group,there is no statistical significance in patient's gender and age(P＞0.05). Male is a little more than female. Compared with the three group, there is significant differences in location, shape, pathological type (P＜0.05). The small polyp group is mainly sessile, no canceration, the huge polyp group is mainly pedunculated. Huge left colon polyp incidence in the highest, and in adenoma of the most. The canceration rate of huge polyp group is higher than that of large great polyp group(P＜0.05).2.The effective removal rate of small, large and huge group are respectively 100%,99.53%(214/215) and 93.18%(41/44). The effective removal rate of large group is higher than the huge group(P＜0.05).3.There were 1093 polyps excised. Postpolypectomy bleeding(PPB) appeared in 18 polyps,including immediate postpolypectomy bleeding(IPPB) and delayed postpolypectomy bleeding (DPPB),no hemorrhea, no enterobrosis. The rate of PPB in small, large and huge polyp group are respectively 0.36%(3/838),5.14%(11/214), and 9.76%(4/41).The rate in small polyp group is the lowest. Compared with large polyp group and huge polyp group,there is no statistical significance in the rate of PPB(P＞0.05).There are 57 polyps in large polyp group and huge polyp group which were adopted method A, the rate of PPB is 12.28%(7/57);and 198 polyps were adopted method B, the rate is 4.04%(8/198). The rate between method A with B is significant differences(P＜0.05).The rate of PPB in the pretreatment group is lower than that in non-pretreatment group.Conclution:1.The size of colonic polyp has nothing to do with the patient's age and gender.2.The larger colonic polyps is, the more canceration rate is.3.Endoscopic treatment of colonic polyps is safe and effective, which is the first alternative therapy for the patients with colonic polyps.4.The size of colonic polyps can not be the determinants that is whether the polyp can be removed by endoscopic resection. As long as taking the proper treatment, huge colonic polyps can also be removed by endoscopic resection. Pretreatment before high-frequency electric resection can decrease the complications.
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