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Cold snare polypectomy without submucosal injection: safety and efficacy in 615 large serrated lesions

Background and study aim  Cold resection is becoming the standard of care for the resection of nonpedunculated colon lesions up to 10 mm in diameter. Sessile serrated adenomas/polyps (SSA/Ps), including those ≥ 10 mm, present various characteristics that make them ideal candidates for cold snare pol...

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Autores principales: Barros, Roberto Augusto, Monteverde, Maria Jose, Dumonceau, Jean-Marc, Barros, Augusto Sebastian, Rainero, German Luis, Barros, Roberto Federico, Jaroslavsky, Maria Jose, de Elizalde, Santiago
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2021
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8382506/
https://www.ncbi.nlm.nih.gov/pubmed/34466368
http://dx.doi.org/10.1055/a-1517-4054
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author Barros, Roberto Augusto
Monteverde, Maria Jose
Dumonceau, Jean-Marc
Barros, Augusto Sebastian
Rainero, German Luis
Barros, Roberto Federico
Jaroslavsky, Maria Jose
de Elizalde, Santiago
author_facet Barros, Roberto Augusto
Monteverde, Maria Jose
Dumonceau, Jean-Marc
Barros, Augusto Sebastian
Rainero, German Luis
Barros, Roberto Federico
Jaroslavsky, Maria Jose
de Elizalde, Santiago
author_sort Barros, Roberto Augusto
collection PubMed
description Background and study aim  Cold resection is becoming the standard of care for the resection of nonpedunculated colon lesions up to 10 mm in diameter. Sessile serrated adenomas/polyps (SSA/Ps), including those ≥ 10 mm, present various characteristics that make them ideal candidates for cold snare polypectomy (CSP). Patients and methods  A prospectively maintained database was searched retrospectively for consecutive patients with lesions ≥ 10 mm resected between March 2013 and March 2018. During that period, all SSA/P-appearing lesions were resected using CSP without submucosal injection, except for lesions with endoscopic suspicion of dysplasia or submucosal invasion. Patients with a pathological diagnosis of SSA/P were included in the analysis. Adverse events were recorded up to 21 days following colonoscopy. Results  615 SSA/Ps ≥ 10 mm were resected during 452 colonoscopy procedures in 379 patients (mean age 54.1 years; standard deviation [SD] 11.9 years). Mean polyp size was 13.7 (SD 5.2) mm; 122 lesions (19.8 %) were ≥ 20 mm and 479 lesions (77.9 %) underwent piecemeal resection. Immediate adverse events included persistent abdominal pain that resolved spontaneously within 2 hours in three patients (0.8 %; 95 % confidence interval [CI] 0.2 %–2.3 %). One patient with persistent intraprocedural bleeding was successfully treated with a hemostatic clip. No late adverse events were detected. Surveillance colonoscopy was performed in 293 patients (77.3 %) at 23.4 (SD 11.6) months following index colonoscopy; residual/recurrent lesions were diagnosed in 23 patients (7.8 %; 95 %CI 5.0 %–11.6 %). Conclusion  CSP without submucosal injection appeared to be safe and effective for the resection of large SSA/Ps.
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spelling pubmed-83825062021-08-30 Cold snare polypectomy without submucosal injection: safety and efficacy in 615 large serrated lesions Barros, Roberto Augusto Monteverde, Maria Jose Dumonceau, Jean-Marc Barros, Augusto Sebastian Rainero, German Luis Barros, Roberto Federico Jaroslavsky, Maria Jose de Elizalde, Santiago Endosc Int Open Background and study aim  Cold resection is becoming the standard of care for the resection of nonpedunculated colon lesions up to 10 mm in diameter. Sessile serrated adenomas/polyps (SSA/Ps), including those ≥ 10 mm, present various characteristics that make them ideal candidates for cold snare polypectomy (CSP). Patients and methods  A prospectively maintained database was searched retrospectively for consecutive patients with lesions ≥ 10 mm resected between March 2013 and March 2018. During that period, all SSA/P-appearing lesions were resected using CSP without submucosal injection, except for lesions with endoscopic suspicion of dysplasia or submucosal invasion. Patients with a pathological diagnosis of SSA/P were included in the analysis. Adverse events were recorded up to 21 days following colonoscopy. Results  615 SSA/Ps ≥ 10 mm were resected during 452 colonoscopy procedures in 379 patients (mean age 54.1 years; standard deviation [SD] 11.9 years). Mean polyp size was 13.7 (SD 5.2) mm; 122 lesions (19.8 %) were ≥ 20 mm and 479 lesions (77.9 %) underwent piecemeal resection. Immediate adverse events included persistent abdominal pain that resolved spontaneously within 2 hours in three patients (0.8 %; 95 % confidence interval [CI] 0.2 %–2.3 %). One patient with persistent intraprocedural bleeding was successfully treated with a hemostatic clip. No late adverse events were detected. Surveillance colonoscopy was performed in 293 patients (77.3 %) at 23.4 (SD 11.6) months following index colonoscopy; residual/recurrent lesions were diagnosed in 23 patients (7.8 %; 95 %CI 5.0 %–11.6 %). Conclusion  CSP without submucosal injection appeared to be safe and effective for the resection of large SSA/Ps. Georg Thieme Verlag KG 2021-08-23 /pmc/articles/PMC8382506/ /pubmed/34466368 http://dx.doi.org/10.1055/a-1517-4054 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) 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 Barros, Roberto Augusto
Monteverde, Maria Jose
Dumonceau, Jean-Marc
Barros, Augusto Sebastian
Rainero, German Luis
Barros, Roberto Federico
Jaroslavsky, Maria Jose
de Elizalde, Santiago
Cold snare polypectomy without submucosal injection: safety and efficacy in 615 large serrated lesions
title Cold snare polypectomy without submucosal injection: safety and efficacy in 615 large serrated lesions
title_full Cold snare polypectomy without submucosal injection: safety and efficacy in 615 large serrated lesions
title_fullStr Cold snare polypectomy without submucosal injection: safety and efficacy in 615 large serrated lesions
title_full_unstemmed Cold snare polypectomy without submucosal injection: safety and efficacy in 615 large serrated lesions
title_short Cold snare polypectomy without submucosal injection: safety and efficacy in 615 large serrated lesions
title_sort cold snare polypectomy without submucosal injection: safety and efficacy in 615 large serrated lesions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8382506/
https://www.ncbi.nlm.nih.gov/pubmed/34466368
http://dx.doi.org/10.1055/a-1517-4054
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