Diagnostic quality of polyps resected by snare polypectomy: Does the type of electrosurgical current used matter?

Lucía C. Fry, Audrey J. Lazenby, Irina Mikolaenko, Brent Barranco, Steffen Rickes, Klaus Mönkemüller

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

BACKGROUND: Traditionally, snare polypectomy is performed using blended, coagulation, or pure cutting electrical current (EC). The aim of this study was to assess and compare the diagnostic quality of polyps obtained by snare polypectomy using two different electrosurgical currents. METHODS: Consecutive patients undergoing colonoscopy underwent polypectomy using either blended EC with a conventional electrosurgical generator (ESG) or using an ESG with a microprocessor that automatically controls cutting and coagulation (Endocut). An experienced blinded gastrointestinal (GI) pathologist evaluated the specimens for diameter, cautery damage (amount and degree), margin evaluability, architecture, and general histologic diagnostic quality. RESULTS: One hundred sixteen patients (69% men, mean age 63.8 ± 15 yr) underwent 148 polypectomies (78 using blended current and 70 using Endocut). We found that the cautery degree was less with the Endocut than with the blended current (p < 0.02). Cautery amount was also higher in polyps resected using blended current (56%) than Endocut (51%) but this difference did not reach statistical significance (p = 0.1). Polyps resected using Endocut had better margin evaluability (75.7% to 60.3%, p = 0.046). The overall tissue architecture was similar in both groups. Polyps removed with blended current had less overall quality as compared to polyps removed by Endocut (p = 0.024). CONCLUSIONS: More extensive tissue damage occurred using blended EC with the conventional ESG than when using Endocut. The quality of the polypectomy specimens was overall better using Endocut. Finally, the ability to evaluate resected polyp margins and overall tissue histology was better with the microprocessor-controlled ESG than with the conventional ESG.

Original languageEnglish (US)
Pages (from-to)2123-2127
Number of pages5
JournalAmerican Journal of Gastroenterology
Volume101
Issue number9
DOIs
StatePublished - Sep 1 2006

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Polyps
Cautery
Microcomputers
Colonoscopy
Histology

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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Diagnostic quality of polyps resected by snare polypectomy : Does the type of electrosurgical current used matter? / Fry, Lucía C.; Lazenby, Audrey J.; Mikolaenko, Irina; Barranco, Brent; Rickes, Steffen; Mönkemüller, Klaus.

In: American Journal of Gastroenterology, Vol. 101, No. 9, 01.09.2006, p. 2123-2127.

Research output: Contribution to journalArticle

Fry, Lucía C. ; Lazenby, Audrey J. ; Mikolaenko, Irina ; Barranco, Brent ; Rickes, Steffen ; Mönkemüller, Klaus. / Diagnostic quality of polyps resected by snare polypectomy : Does the type of electrosurgical current used matter?. In: American Journal of Gastroenterology. 2006 ; Vol. 101, No. 9. pp. 2123-2127.
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abstract = "BACKGROUND: Traditionally, snare polypectomy is performed using blended, coagulation, or pure cutting electrical current (EC). The aim of this study was to assess and compare the diagnostic quality of polyps obtained by snare polypectomy using two different electrosurgical currents. METHODS: Consecutive patients undergoing colonoscopy underwent polypectomy using either blended EC with a conventional electrosurgical generator (ESG) or using an ESG with a microprocessor that automatically controls cutting and coagulation (Endocut). An experienced blinded gastrointestinal (GI) pathologist evaluated the specimens for diameter, cautery damage (amount and degree), margin evaluability, architecture, and general histologic diagnostic quality. RESULTS: One hundred sixteen patients (69{\%} men, mean age 63.8 ± 15 yr) underwent 148 polypectomies (78 using blended current and 70 using Endocut). We found that the cautery degree was less with the Endocut than with the blended current (p < 0.02). Cautery amount was also higher in polyps resected using blended current (56{\%}) than Endocut (51{\%}) but this difference did not reach statistical significance (p = 0.1). Polyps resected using Endocut had better margin evaluability (75.7{\%} to 60.3{\%}, p = 0.046). The overall tissue architecture was similar in both groups. Polyps removed with blended current had less overall quality as compared to polyps removed by Endocut (p = 0.024). CONCLUSIONS: More extensive tissue damage occurred using blended EC with the conventional ESG than when using Endocut. The quality of the polypectomy specimens was overall better using Endocut. Finally, the ability to evaluate resected polyp margins and overall tissue histology was better with the microprocessor-controlled ESG than with the conventional ESG.",
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N2 - BACKGROUND: Traditionally, snare polypectomy is performed using blended, coagulation, or pure cutting electrical current (EC). The aim of this study was to assess and compare the diagnostic quality of polyps obtained by snare polypectomy using two different electrosurgical currents. METHODS: Consecutive patients undergoing colonoscopy underwent polypectomy using either blended EC with a conventional electrosurgical generator (ESG) or using an ESG with a microprocessor that automatically controls cutting and coagulation (Endocut). An experienced blinded gastrointestinal (GI) pathologist evaluated the specimens for diameter, cautery damage (amount and degree), margin evaluability, architecture, and general histologic diagnostic quality. RESULTS: One hundred sixteen patients (69% men, mean age 63.8 ± 15 yr) underwent 148 polypectomies (78 using blended current and 70 using Endocut). We found that the cautery degree was less with the Endocut than with the blended current (p < 0.02). Cautery amount was also higher in polyps resected using blended current (56%) than Endocut (51%) but this difference did not reach statistical significance (p = 0.1). Polyps resected using Endocut had better margin evaluability (75.7% to 60.3%, p = 0.046). The overall tissue architecture was similar in both groups. Polyps removed with blended current had less overall quality as compared to polyps removed by Endocut (p = 0.024). CONCLUSIONS: More extensive tissue damage occurred using blended EC with the conventional ESG than when using Endocut. The quality of the polypectomy specimens was overall better using Endocut. Finally, the ability to evaluate resected polyp margins and overall tissue histology was better with the microprocessor-controlled ESG than with the conventional ESG.

AB - BACKGROUND: Traditionally, snare polypectomy is performed using blended, coagulation, or pure cutting electrical current (EC). The aim of this study was to assess and compare the diagnostic quality of polyps obtained by snare polypectomy using two different electrosurgical currents. METHODS: Consecutive patients undergoing colonoscopy underwent polypectomy using either blended EC with a conventional electrosurgical generator (ESG) or using an ESG with a microprocessor that automatically controls cutting and coagulation (Endocut). An experienced blinded gastrointestinal (GI) pathologist evaluated the specimens for diameter, cautery damage (amount and degree), margin evaluability, architecture, and general histologic diagnostic quality. RESULTS: One hundred sixteen patients (69% men, mean age 63.8 ± 15 yr) underwent 148 polypectomies (78 using blended current and 70 using Endocut). We found that the cautery degree was less with the Endocut than with the blended current (p < 0.02). Cautery amount was also higher in polyps resected using blended current (56%) than Endocut (51%) but this difference did not reach statistical significance (p = 0.1). Polyps resected using Endocut had better margin evaluability (75.7% to 60.3%, p = 0.046). The overall tissue architecture was similar in both groups. Polyps removed with blended current had less overall quality as compared to polyps removed by Endocut (p = 0.024). CONCLUSIONS: More extensive tissue damage occurred using blended EC with the conventional ESG than when using Endocut. The quality of the polypectomy specimens was overall better using Endocut. Finally, the ability to evaluate resected polyp margins and overall tissue histology was better with the microprocessor-controlled ESG than with the conventional ESG.

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