Background:

There are few methods to verify complete resection of small-diminutive polyps post-resection with biopsy forceps.

Objective:

To evaluate the efficacy in the delimitation and enhancement of the resection edges, of a new method elevating the mucosa with a hydrojet system post-resection with biopsy forceps of small-diminutive colorectal polyps.

Methods:

Prospective study (May 2014-2015), Policlínica Metropolitana, using an Olympus180® video colonoscope, ERBE hydrojet pump. Patients with small-diminutive colorectal lesions were included. Each detected polyp was characterized: white light and NBI. Sano-Emura classification was recorded, histology was reported. Technique performed: resection of the polyp with biopsy forceps, subsequent irrigation of the resection area with hydrojet pump (100 cc / minute); evaluation of the area, complete resection if it was necessary.

Results:

A total (158) small-minute polyps (84 patients), mean age 59 years (30-91). Right colon (52), left (72), anorectum (34). Sano Emura classification: Type I 125 (79.1%), Type II 33 (20.9%). Of the 158, in 105 polyps (66.45%) the technique allowed to enhance the edges and verify lesion free edges. Of the 53 with residual tissue post-resection in a second attempt, a technique was applied and residual tissue was verified in 2 (3.77%), performing a third resection with application of the technique verifying free margins of the lesion. Post-resection mucosal irrigation allowed modifying the therapeutic decision: 33.54% and 3.77% respectively. Of the 52 right colon polyps, the technique revealed borders with post-resection lesions in 15, modifying the therapeutic decision in 29%.

Conclusions:

The new method of mucosal elevation with hydrojet irrigation post resection with biopsy forceps of small-minute colorectal polyps appears to be an effective technique in delimiting and enhancing resection edges, modifying therapeutic decisions in terms of safety and curability.