COLD SNARE POLYPECTOMY: A SAFE PROCEDURE FOR REMOVING SMALL NON-PEDUNCULATED COLORECTAL LESIONS
ABSTRACT Background: Polypectomy is an important treatment option for preventing colorectal cancer. Incomplete polyp resection (IPR) is recognized as a risk factor for interval cancer. Objective: The primary objective was to evaluate the complete polyp resection (CPR) rate for cold snare polypecto...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE)
2023-11-01
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| Series: | Arquivos de Gastroenterologia |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032023000400470&lng=en&tlng=en |
| _version_ | 1827631644457041920 |
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| author | Carlos Eduardo Oliveira Dos SANTOS Daniele MALAMAN Ivan David Arciniegas SANMARTIN Ari Ben-Hur Stefani LEÃO Isadora Zanotelli BOMBASSARO Júlio Carlos PEREIRA-LIMA |
| author_facet | Carlos Eduardo Oliveira Dos SANTOS Daniele MALAMAN Ivan David Arciniegas SANMARTIN Ari Ben-Hur Stefani LEÃO Isadora Zanotelli BOMBASSARO Júlio Carlos PEREIRA-LIMA |
| author_sort | Carlos Eduardo Oliveira Dos SANTOS |
| collection | DOAJ |
| description | ABSTRACT Background: Polypectomy is an important treatment option for preventing colorectal cancer. Incomplete polyp resection (IPR) is recognized as a risk factor for interval cancer. Objective: The primary objective was to evaluate the complete polyp resection (CPR) rate for cold snare polypectomy (CSP) in small non-pedunculated polyps and, secondarily, specimen retrieval and complication rates. Methods: We prospectively evaluated 479 polyps <10 mm removed by CSP in 276 patients by an inexperienced endoscopist. Results: A total of 476 polyps (99.4%) were resected en bloc. A negative margin (classified as CPR) was observed in 435 polyps (90.8%). An unclear or positive margin (classified as IPR) was observed in 43 cases (9.0%) and 1 case (0.2%), respectively, for an overall IPR rate of 9.2% (44/479). The IPR rate was 12.2% in the first half of cases and 5.9% in the second half (P=0.02). Dividing into tertiles, the IPR rate was 15.0% in the first tertile, 6.9% in the second tertile, and 5.7% in the third tertile (P=0.01). Dividing into quartiles, the IPR rate was 15.8% in the first quartile and 5.9% in the fourth quartile (P=0.03). The IPR rate was 6.3% for type 0-IIa lesions and 14.1% for type 0-Is lesions (P=0.01). For serrated and adenomatous lesions, the IPR rate was 9.2%. Specimen retrieval failed in 3.6% of cases. Immediate bleeding (>30 s) occurred in 1 case (0.2%), treated with argon plasma coagulation. No delayed bleeding or perforation occurred. Conclusion: CSP is a safe technique that provides good results for the resection of small non-pedunculated polyps, with a short learning curve. |
| first_indexed | 2024-03-09T14:24:15Z |
| format | Article |
| id | doaj.art-7931d9a7a49a4f14b511052df9670700 |
| institution | Directory Open Access Journal |
| issn | 1678-4219 |
| language | English |
| last_indexed | 2024-03-09T14:24:15Z |
| publishDate | 2023-11-01 |
| publisher | Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE) |
| record_format | Article |
| series | Arquivos de Gastroenterologia |
| spelling | doaj.art-7931d9a7a49a4f14b511052df96707002023-11-28T07:48:45ZengInstituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE)Arquivos de Gastroenterologia1678-42192023-11-0160447047710.1590/s0004-2803.23042023-115COLD SNARE POLYPECTOMY: A SAFE PROCEDURE FOR REMOVING SMALL NON-PEDUNCULATED COLORECTAL LESIONSCarlos Eduardo Oliveira Dos SANTOShttps://orcid.org/0000-0003-4333-3182Daniele MALAMANhttps://orcid.org/0000-0003-0718-2372Ivan David Arciniegas SANMARTINhttps://orcid.org/0000-0003-2074-5221Ari Ben-Hur Stefani LEÃOhttps://orcid.org/0000-0003-3146-2622Isadora Zanotelli BOMBASSAROhttps://orcid.org/0000-0001-5282-8086Júlio Carlos PEREIRA-LIMAhttps://orcid.org/0000-0002-6070-6916ABSTRACT Background: Polypectomy is an important treatment option for preventing colorectal cancer. Incomplete polyp resection (IPR) is recognized as a risk factor for interval cancer. Objective: The primary objective was to evaluate the complete polyp resection (CPR) rate for cold snare polypectomy (CSP) in small non-pedunculated polyps and, secondarily, specimen retrieval and complication rates. Methods: We prospectively evaluated 479 polyps <10 mm removed by CSP in 276 patients by an inexperienced endoscopist. Results: A total of 476 polyps (99.4%) were resected en bloc. A negative margin (classified as CPR) was observed in 435 polyps (90.8%). An unclear or positive margin (classified as IPR) was observed in 43 cases (9.0%) and 1 case (0.2%), respectively, for an overall IPR rate of 9.2% (44/479). The IPR rate was 12.2% in the first half of cases and 5.9% in the second half (P=0.02). Dividing into tertiles, the IPR rate was 15.0% in the first tertile, 6.9% in the second tertile, and 5.7% in the third tertile (P=0.01). Dividing into quartiles, the IPR rate was 15.8% in the first quartile and 5.9% in the fourth quartile (P=0.03). The IPR rate was 6.3% for type 0-IIa lesions and 14.1% for type 0-Is lesions (P=0.01). For serrated and adenomatous lesions, the IPR rate was 9.2%. Specimen retrieval failed in 3.6% of cases. Immediate bleeding (>30 s) occurred in 1 case (0.2%), treated with argon plasma coagulation. No delayed bleeding or perforation occurred. Conclusion: CSP is a safe technique that provides good results for the resection of small non-pedunculated polyps, with a short learning curve.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032023000400470&lng=en&tlng=enColorectal polypscold snare polypectomyincomplete polyp resection |
| spellingShingle | Carlos Eduardo Oliveira Dos SANTOS Daniele MALAMAN Ivan David Arciniegas SANMARTIN Ari Ben-Hur Stefani LEÃO Isadora Zanotelli BOMBASSARO Júlio Carlos PEREIRA-LIMA COLD SNARE POLYPECTOMY: A SAFE PROCEDURE FOR REMOVING SMALL NON-PEDUNCULATED COLORECTAL LESIONS Arquivos de Gastroenterologia Colorectal polyps cold snare polypectomy incomplete polyp resection |
| title | COLD SNARE POLYPECTOMY: A SAFE PROCEDURE FOR REMOVING SMALL NON-PEDUNCULATED COLORECTAL LESIONS |
| title_full | COLD SNARE POLYPECTOMY: A SAFE PROCEDURE FOR REMOVING SMALL NON-PEDUNCULATED COLORECTAL LESIONS |
| title_fullStr | COLD SNARE POLYPECTOMY: A SAFE PROCEDURE FOR REMOVING SMALL NON-PEDUNCULATED COLORECTAL LESIONS |
| title_full_unstemmed | COLD SNARE POLYPECTOMY: A SAFE PROCEDURE FOR REMOVING SMALL NON-PEDUNCULATED COLORECTAL LESIONS |
| title_short | COLD SNARE POLYPECTOMY: A SAFE PROCEDURE FOR REMOVING SMALL NON-PEDUNCULATED COLORECTAL LESIONS |
| title_sort | cold snare polypectomy a safe procedure for removing small non pedunculated colorectal lesions |
| topic | Colorectal polyps cold snare polypectomy incomplete polyp resection |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032023000400470&lng=en&tlng=en |
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