Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Evaluation of a new method, "non-injection resection using bipolar soft coagulation mode (NIRBS)", for colonic adenomatous lesions

  • Mitsuo Tokuhara (Department of Gastroenterology, Japan Community Healthcare Organization Hoshigaoka Medical Center) ;
  • Masaaki Shimatani (Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University Hirakata Hospital) ;
  • Kazunari Tominaga (Department of Gastroenterology, Japan Community Healthcare Organization Hoshigaoka Medical Center) ;
  • Hiroko Nakahira (Department of Gastroenterology, Japan Community Healthcare Organization Hoshigaoka Medical Center) ;
  • Takuya Ohtsu (Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University Hirakata Hospital) ;
  • Katsuyasu Kouda (Department of Hygiene and Public Health, Kansai Medical University Hirakata Hospital) ;
  • Makoto Naganuma (Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University Hirakata Hospital)
  • Received : 2022.08.03
  • Accepted : 2022.12.16
  • Published : 2023.09.30
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Abstract

Background/Aims: Endoscopic resection of all colorectal adenomatous lesions with a low complication rate, simplicity, and negative residuals is challenging. Hence, we developed a new method called "non-injection resection using bipolar soft coagulation mode (NIRBS)" method, adapted for colorectal lesions. In addition, we evaluated the effectiveness of this method. Methods: We performed NIRBS throughout a 12-month period for all colorectal lesions which snare resection was acceptable without cancerous lesions infiltrating deeper than the submucosal layer. Results: A total of 746 resected lesions were included in the study, with a 4.5 mm mean size (range, 1-35 mm). The major pathological breakdowns were as follows: 64.3% (480/746) were adenomas, and 5.0% (37/746) were intraepithelial adenocarcinomas (Tis lesions). No residuals were observed in any of the 37 Tis lesions (mean size, 15.3 mm). Adverse events included bleeding (0.4%) but no perforation. Conclusions: NIRBS allowed the resection of multiple lesions with simplicity because of the non-injection and without perforating due to the minimal burn effect of the bipolar snare set in the soft coagulation mode. Therefore, NIRBS can be used to resect adenomatous lesions easily, including Tis lesions, from small to large lesions without leaving residuals.

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References

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