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Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2025; 17(11): 108763
Published online Nov 27, 2025. doi: 10.4240/wjgs.v17.i11.108763
Effects of endoscopic mucosal resection and argon plasma coagulation on postoperative recovery and complications in elderly colon polyp patients
Hong-Tao Li, Feng Liu, Peng-Fei Mei, Xia Lei, Shen-Ying Liu
Hong-Tao Li, Peng-Fei Mei, Xia Lei, Shen-Ying Liu, Department of Digestive, Jiujiang University Affiliated Hospital, Jiujiang 332000, Jiangxi Province, China
Feng Liu, Medical College, First Affiliated Hospital of Gannan Medical University, Ganzhou 332000, Jiangxi Province, China
Author contributions: Li HT wrote the paper, designed and performed the research; Li HT, Mei PF, Lei X, and Liu SY provided endoscopic diagnosis and treatment; Liu F designed the research and contributed to the analysis; Liu SY designed the research and supervised the report.
Institutional review board statement: This study was approved by the Ethics Committee of the Jiujiang University Affiliated Hospital (Approval No. jjumer-b-2024-0720).
Informed consent statement: All authors voluntarily signed the informed consent form.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shen-Ying Liu, Department of Digestive, Jiujiang University Affiliated Hospital, No. 57 Xunya East Road, Jiujiang 332000, Jiangxi Province, China. shenying202401@163.com
Received: May 20, 2025
Revised: June 30, 2025
Accepted: September 26, 2025
Published online: November 27, 2025
Processing time: 188 Days and 19 Hours
Abstract
BACKGROUND

Colon polyps represent a significant clinical challenge in elderly patients. While endoscopic mucosal resection (EMR) and argon plasma coagulation (APC) are widely used, their comparative effectiveness in elderly populations remains unclear, particularly regarding postoperative recovery and complication profiles.

AIM

To compare the postoperative recovery, complications and efficacy of EMR and APC in elderly patients with colonic polyps.

METHODS

We retrospectively analyzed clinical data from 224 elderly patients with colon polyps treated at our center between January 2021 and July 2024. All patients were divided into the EMR group and APC group according to the surgical method they received. By comparing the operation time, intraoperative bleeding situation, hospital stays, postoperative inflammatory response index, complication rate and recurrence status of the two groups, the effect of the two surgical methods was comprehensively evaluated.

RESULTS

The APC group exhibited superior outcomes in terms of operative time (10.63 minutes vs 13.27 minutes, P < 0.001), intraoperative bleeding situation (39.00% vs 52.42%, P = 0.031), and length of hospital stay (1.63 days vs 3.87 days, P < 0.001) compared to the EMR group. The one-time resection rate of the APC group (94.69%) was higher than that of the EMR group (89.14%) (P = 0.026). The overall effective rates of the two groups were 94.35% and 92.00%, respectively. Postoperative procalcitonin and C-reactive protein levels were lower in the APC group than in the EMR group (P < 0.001). The incidence of complications was comparable between the two groups (P = 0.159). The recurrence rate was lower in the APC group (2.00%) than in the EMR group (8.06%) (P = 0.045).

CONCLUSION

For elderly patients with colon polyps, APC showed certain advantages compared with EMR in promoting postoperative recovery, reducing the inflammatory response and the risk of complications. However, the study is limited by its single-center retrospective design and short follow-up period, and further multicenter prospective studies are needed to validate the findings.

Keywords: Colon polyps; Endoscopic mucosal resection; Argon plasma coagulation; Postoperative recovery; Complications; Elderly patients

Core Tip: This study compared endoscopic mucosal resection and argon plasma coagulation (APC) in elderly (≥ 50 years) colon polyp patients. APC demonstrated superior outcomes, including shorter operative time (10.63 minutes vs 13.27 minutes, P < 0.001), reduced intraoperative bleeding (39.00% vs 52.42%, P = 0.031), and lower inflammatory markers (procalcitonin and C-reactive protein, P < 0.001) compared to endoscopic mucosal resection. While both techniques showed similar overall efficacy, APC had a lower recurrence rate (2.00% vs 8.06%, P = 0.045). These findings suggest that APC may be preferable for small polyps (< 1.5 cm) in elderly patients due to faster recovery and reduced complications.