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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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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
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author Abe, Yasuhiro
Nabeta, Haruaki
Koyanagi, Ryota
Nakamichi, Taro
Hirashima, Hayato
Lefor, Alan Kawarai
Shinozaki, Satoshi
author_facet Abe, Yasuhiro
Nabeta, Haruaki
Koyanagi, Ryota
Nakamichi, Taro
Hirashima, Hayato
Lefor, Alan Kawarai
Shinozaki, Satoshi
author_sort Abe, Yasuhiro
collection PubMed
description 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
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spelling pubmed-58030022018-02-08 Extended cold snare polypectomy for small colorectal polyps increases the R0 resection rate Abe, Yasuhiro Nabeta, Haruaki Koyanagi, Ryota Nakamichi, Taro Hirashima, Hayato Lefor, Alan Kawarai Shinozaki, Satoshi Endosc Int Open 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 © Georg Thieme Verlag KG 2018-02 2018-02-07 /pmc/articles/PMC5803002/ /pubmed/29423436 http://dx.doi.org/10.1055/s-0043-125312 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Abe, Yasuhiro
Nabeta, Haruaki
Koyanagi, Ryota
Nakamichi, Taro
Hirashima, Hayato
Lefor, Alan Kawarai
Shinozaki, Satoshi
Extended cold snare polypectomy for small colorectal polyps increases the R0 resection rate
title Extended cold snare polypectomy for small colorectal polyps increases the R0 resection rate
title_full Extended cold snare polypectomy for small colorectal polyps increases the R0 resection rate
title_fullStr Extended cold snare polypectomy for small colorectal polyps increases the R0 resection rate
title_full_unstemmed Extended cold snare polypectomy for small colorectal polyps increases the R0 resection rate
title_short Extended cold snare polypectomy for small colorectal polyps increases the R0 resection rate
title_sort extended cold snare polypectomy for small colorectal polyps increases the r0 resection rate
url 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
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