Novel Endoscopic Technique in Treating Colon Neoplasms with Improved Clinical Outcomes

Ismailov Saidmurad Ibragimovich^1,2, Djumaniyazov Djavokhir Azatbaevich¹, Yigitaliev Sardor Khusanboevich², Yakubov Farkhod Radjabovich³,  Sapaev Duschan Shukhratovich³

This study demonstrated a novel endoscopic method enhancing polyp removal efficacy, reducing complications, and lowering recurrence rates significantly.

Abstract

Background: Colorectal polyps are a significant concern due to their potential to develop into colorectal cancer (CRC), a leading cause of cancer mortality. While many polyps are benign, a subset is "complex" and challenging to resect endoscopically. Current methods for polyp removal include cold excision, electrocoagulation, endoscopic mucosal resection (EMR), and endoscopic submucosal dissection (ESD), with varying success and complication rates. This study evaluates a new endoscopic excision technique involving a gel injection and diode laser system. Methods: The study included 208 patients with superficial neoplastic lesions of the colon, divided into a comparison group (112 patients, 170 polyps) and a main group (96 patients, 152 polyps). The comparison group underwent conventional excision techniques, while the main group received the new gel injection and diode laser excision method. Outcomes measured included complete resection rates, complication rates, recurrence rates, and hospital stay duration. Results: The main group showed a higher complete resection rate (70.4% vs. 57.1%, p=0.014) and lower recurrence rates (5.0% vs. 24.2%, p<0.001) compared to the comparison group. Clinically significant bleeding during and after procedures was also reduced in the main group (0% intraoperative, 0.7% postoperative) compared to the comparison group (4.7% intraoperative, 2.4% postoperative, p=0.012). The average hospital stay was shorter in the main group (3.4±1.0 days) compared to the comparison group (4.0±1.2 days, p<0.05). Conclusion: The new endoscopic excision technique using gel injection and diode laser significantly improves the complete resection rate, reduces complications and recurrence rates, and shortens hospital stay for patients with superficial colonic neoplastic lesions. This method offers a promising alternative for the endoscopic treatment of complex colorectal polyps.

Keywords: Colon polyps, endoscopic resection, laser excision, recurrence, complications

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