Complications of endoscopic polypectomy and endoscopic mucosal resection in the stomach

The complications related to endoscopic polypectomy (EP) and endoscopic mucosal resection (EMR) were analyzed. At our hospital, EP and EMR were performed in 346 and 223 cases, respectively, from Jan. 1984 to Apr. 1994. The incidence of requiring endoscopic hemostasis was as follows ; EP : 13.0% (slight, 41 cases ; moderate, 3 cases ; severe, 1 case), and EMR, 14.3% (slight, 23 cases ; moderate, 8 cases ; severe, 1 case). The incidence of perforation was EP ; 0.28% (1 case) and EMR ; 0.45% (1 case), respectively. The incidence of moderate and severe hemorrhage related to EMR was higher than that of EP. In the cases which underwent EP, the factors of 1) maximum length of the resected specimen and 2) lesion at the C-region were assosiated with tendency to hemorrhage. However, no relationship was noted between hemorrhage and histological diagnosis (hyperplastic polyp, adenoma, cancer). In the cases which underwent EMR, no difference was also noted in the incidence between adenoma and mucosal cancer. All cases of hemorrhage recovered by endoscopic ethanol injection and there was no need for surgical treatment. No patient revealed rebleeding. Perforation occured due to ensnaring of the proper muscular layer in both cases.