Acute Renal Failure

We have found colonoscopic polypectomy to be a safe and efficient procedure. It is well tolerated, even by elderly, high-risk patients. The procedure at times is diicult and time-consuming. We would advise, therefore, that only those who have had gastrointestinal endoscopy experience should undertake it. Our findings are similar to those reported by other investigators as to size, location, pathologic features, complications and incidence of malignancy in colonic polyps." It is too early to ascertain whether complete removal of malignant adenomatous polyps by colonoscopic cautery snare will prove to be a curative procedure. At present we would advise that patients with malignant changes be treated by laparotomy and segmental resection. Longterm follow-up of a significant number of cases is needed to show whether we are removing these lesions completely enough and, therefore, whether localized carcinoma in pedunculated adenomatous polyps can be cured without operation. Colonoscopic polypectomy, as a non-invasive procedure, has major advantages over laparotomy, colotomy and polypectomy. The average length of time spent in hospital in our series was 36 hours and the average time lost from work was 48 hours. The patient usually is able to return to regular activity in 72 hours. A normal diet is resumed on the first day after polypectomy and the cost to the patient or the insurance carrier is reduced by approximately 75 percent.