Endoscopic Microwave Therapy for 1,265 Cases of Gastrointestinal Polyps

Materials and Methods

There were 1,265 patients with gastrointestinal polyps, including 780 males and 485 females; their ages ranged from 11 to 74 years, with a total of 1,566 polyps (including 6 cases of multiple colonic polyps). These polyps were distributed as follows: 74 in the esophagus, 48 at the gastroesophageal junction, 405 in the stomach, and 982 in the colorectum. The smallest polyp was about the size of a grain of rice, while the largest… 4.5cm × 3.0cm ;All cases underwent preoperative examination for inflammatory and proliferative polyps, totaling 1,126 cases.

A multifunctional microwave therapy device is used. Pre‑procedural preparation and precautions are the same as those for endoscopic examination. Fifteen minutes before the procedure, inject 0.5 mg of atropine along with 654–210 mg to inhibit gastrointestinal peristalsis and reduce the secretion of digestive fluids. Select different power levels, durations, and frequencies based on polyp size. Polyps < 1.0cm Apply 50 mA for 3–5 seconds, cauterizing 1–4 times; polyps > 1.0cm Generally, use 20–30 W for 6–10 seconds, applying electrocautery 4–7 times until the polyp is locally vaporized or appears white and coagulated. For pedunculated polyps, it’s more effective to aim the electrocautery at both sides of the base.

Results and Discussion

In this group of cases, polyps disappeared in 90.2% after a single treatment. For the 123 patients with larger or more numerous polyps, polypectomy was performed in 2–4 sessions, or multiple sessions using microwave coagulation were employed to remove the polyps. All patients who underwent two or more treatments showed complete efficacy. Follow‑up examinations revealed that, in some cases, ulcerative changes on the mucosal surface could be observed within one week postoperatively, while the mucosa returned to normal after more than one week. Among the 216 patients followed up, two (one for over a year and the other for 2 years and 7 months) underwent surgical treatment for adenoma malignancy; no other cases experienced recurrence. During the treatment process, there were no instances of major hemorrhage or perforation; only a few patients experienced mild postoperative abdominal pain, which improved with rest or oral administration of fleroxacin. Three patients with P-J syndrome had multiple large polyps; they experienced slight postoperative bleeding, but recovered quickly following internal medical treatment.

     Both domestically and internationally, it has been proven that microwave therapy achieves a 100% success rate in polyp removal. In this group, polyps with a diameter of less than… 1.0cm For broad-based or short‑pedicled polyps, the “top electrocautery with pressure” method is employed; for long‑pedicled polyps, the “bilateral base approach” is used. These techniques yield good results, allowing for single‑session ablation with an efficacy rate exceeding 90%. When performing coagulation and vaporization, it is best to apply short-duration, multiple coagulation cycles—this approach minimizes the impact of intestinal peristalsis and ensures that endoscopic heating remains safe and reliable. 1.0cm Multiple polyps can be removed in batches of dozens each time, > 2.0cm For long pedunculated polyps, high-frequency electrocautery is the preferred method, as it facilitates complete removal of the polyp for histopathological examination, thereby increasing the detection rate of malignant transformation while also preventing incomplete ablation or excessive tissue damage caused by overly high power settings, which could lead to complications such as bleeding or perforation. In this group, we treated three cases of P-J syndrome with dozens of polyps of varying sizes and shapes within the colon. After performing multiple, phased electrocoagulation resections, follow-up revealed that the intestinal mucosa in one case had healed well with no recurrence. During treatment, any tissue scabs that formed on the microwave antenna electrode should be removed promptly to avoid compromising therapeutic efficacy—simply by retracting the antenna outward or repeatedly rotating the knob while gently sliding it along the gastrointestinal wall.

   The thermal energy used in microwave therapy abroad reaches 42~ 48°C It can effectively destroy cancer cells. In addition, it can be used to treat esophageal anastomotic strictures, as reported in domestic studies. We performed microwave therapy on 2 patients with early-stage esophageal cancer, 4 patients with advanced esophageal cancer strictures, and 2 patients with anastomotic stricture due to esophageal cancer, successfully alleviating their difficulty in eating and prolonging their survival time. In summary, microwave therapy is simple to perform, cost‑effective, safe, and reliable; it does not require hospitalization and is associated with few complications, making it ideal for promotion in primary care hospitals.