A second colonoscopy using a new, specialized technique may be safer than surgery for patients whose lesions can't initially be removed endoscopically, according to a study in the January issue of the journal Gastrointestinal Endoscopy.
The technique, known as endoscopic mucosal resection, involves a needle passed through the endoscope and an injection of liquid solution under large flat and sessile lesions to lift them away from deeper intestinal tissue. Then they can be resected with a snare. The study's authors report that 71% of the lesions referred for surgery turned out to be non-cancerous polyps, and in 26% of the cases, a previous attempt at removal had failed. The technique is not advised for patients with biopsy-proven cancer.
None of the 36 patients in the study experienced serious adverse events and only 6% required overnight observation in a hospital. This is a significant benefit, since surgical resection is known to entail a low but significant risk of serious adverse events.