Endoclip-assisted resection of large pedunculated colon polyps

Background: Large pedunculated colorectal polyps are often difficult to remove endoscopically. Methods: Four patients with giant pedunculated polyps (>3 cm) underwent an endoscopic procedure in which the polyp stalk was ligated with multiple clips and resected with a needle-knife papillotome. Results: No complications occurred either during or immediately after the procedure. Mean size of the resected polyps was 4.8 +/- 1.2 cm (range 3 to 6 cm). Mean time for the entire procedure was 31 +/- 5 minutes (range 25 to 45). No bleeding was found after a mean follow-up period of 4.3 +/- 1.1 months (range 3 to 6 months). Conclusions: Although technical refinements are necessary to make the procedure easier and faster, this approach might represent the only option for selected patients who would otherwise need surgical resection of large pedunculated colonic polyps.