Experience with 1000 colonoscopic polypectomies.

Experience with 1000 consecutive polypectomies in 591 patients, from December 1975 to October 1982, is reviewed. There were 633 adenomas, 292 hyperplastic, and 75 miscellaneous polyps. While eight minor bleeding episodes (0.8%) occurred, there were no major complications (perforations or bleeding requiring transfusion). The polyp retrieval rate was 97.9%. Of the 633 adenomas, seven (1.1%) had in situ carcinoma and ten (1.6%) invasive. Eight of the invasive group underwent colon resection with no positive nodes present. Anatomic location demonstrated a shift to the right side of the colon. Three hundred thirty-six (53.1%) were in the rectosigmoid; 134 (21.3%) were in the left colon; 79 (12.3%) were in the transverse colon; and 84 (13.3%) were in the right colon and cecum. Patients who have undergone benign polypectomy are colonoscoped again in 1 year, and, if negative, every 3 years thereafter. Postpolypectomy patients with malignant adenomas require closer observation. Endoscopic polypectomy, with its lower morbidity and mortality, has revolutionized the treatment of the colon polyp. It is also more cost-effective, with outpatient polypectomy being 29 times less expensive and inpatient polypectomy four times less expensive than transabdominal polypectomy.