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Extended cold snare polypectomy for small colorectal polyps increases the R0 resection rate

BACKGROUND AND STUDY AIMS:  Despite widespread use of cold snare polypectomy (CSP), the R0 resection rate is not well documented. We perform extended CSP, resecting polyps with a > 1 mm circumferential margin. The aim of this study is to compare the R0 resection rate of extended CSP with conventi...

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Detalles Bibliográficos
Autores principales: Abe, Yasuhiro, Nabeta, Haruaki, Koyanagi, Ryota, Nakamichi, Taro, Hirashima, Hayato, Lefor, Alan Kawarai, Shinozaki, Satoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: © Georg Thieme Verlag KG 2018
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803002/
https://www.ncbi.nlm.nih.gov/pubmed/29423436
http://dx.doi.org/10.1055/s-0043-125312
Descripción
Sumario:BACKGROUND AND STUDY AIMS:  Despite widespread use of cold snare polypectomy (CSP), the R0 resection rate is not well documented. We perform extended CSP, resecting polyps with a > 1 mm circumferential margin. The aim of this study is to compare the R0 resection rate of extended CSP with conventional CSP and to assess safety. PATIENTS AND METHODS : From April 2014 to September 2016, 712 non-pedunculated colorectal polyps, < 10 mm in size, resected using CSP from 316 patients were retrospectively analyzed. RESULTS:  We divided lesions into conventional CSP (n = 263) and extended CSP groups (n = 449). The baseline characteristics of these two groups were not significantly different in univariate or multivariate analyses. Sessile polyps comprised 94 % (668/712), and the remaining were flat-elevated polyps. Mean size of polyps (±standard deviation) was 4.2 ± 1.5 mm. The most frequent pathology was low grade adenoma (97 %, 689/712). The R0 resection rate was significantly higher in the extended CSP group (439/449 [98 %]) than in the conventional CSP group (222/263 [84 %], P  < 0.001). There was no delayed bleeding or perforation in either group (conventional CSP group, 0/263, 95 % confidence interval: 0.0 – 1.4 % and extended CSP group, 0/449, 95 % confidence interval: 0.0 – 0.8 %). CONCLUSIONS:  Extended CSP results in a higher R0 resection rate compared with conventional CSP. Extended CSP did not result in a higher rate of delayed bleeding or perforation. Extended CSP is a safe and promising procedure for endoscopic resection of non-pedunculated colorectal polyps < 10 mm in size