Tu1057 THE RISK FACTORS OF BLEEDING IN COLD SNARE POLYPECTOMY FOR SMALL COLON POLYPS AND THE EFFECTS OF SUBMUCOSAL INJECTION

Abstract Background and study aims Cold polypectomy is becoming popular for treatment of colon polyps due to its safety and convenience, but there is still the problem of tumor remnants. Because linked color imaging (LCI) improves polyp visibility, cold polypectomy under LCI is anticipated to reduce the tumor remnant rate. Therefore, we investigated the usefulness of this procedure. Patients and methods Fifty patients scheduled to undergo cold polypectomy for treatment of colon polyps < 10 mm and assumed to be adenomas were registered prospectively. After performing cold snare polypectomy (CSP) under LCI, biopsy was performed at two resection margin sites for each polyp to determine the tumor remnant rate. Results A total of 145 lesions were treated by CSP. Of the 139 lesions in which polyps were retrievable and diagnosed as adenomas pathologically, one lesion was recognized as a remnant adenoma on biopsy (remnant rate: 0.7 % [95 % CI: 0.0–4.4]). This remnant rate was extremely low. Treatment results were extremely promising given that en bloc resection, post-procedure bleeding, and perforation rates were 100 %, 0 %, and 0 %, respectively. Conclusion Cold snare polypectomy under LCI may be an effective treatment method capable of reducing the tumor remnant rate. This trial was approved by our Institutional Ethics Committee and registered at the University Hospital Medical Information Network (UMIN 000033690).

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Removal and Retrieval of Small Colon Polyps By Cold Snare Polypectomy

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2008.03.931 ◽

2008 ◽

Vol 67 (5) ◽

pp. AB314

Author(s):

J. Haringsma ◽

H. Van Dekken ◽

E.J. Kuipers

Keyword(s):

Colon Polyps ◽

Cold Snare Polypectomy ◽

Snare Polypectomy

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Cold snare polypectomy for large sessile serrated lesions is safe but follow-up is needed: A single-centre retrospective study

United European Gastroenterology Journal ◽

10.1177/2050640620964641 ◽

2020 ◽

pp. 205064062096464

Author(s):

Naohisa Yoshida ◽

Ken Inoue ◽

Yuri Tomita ◽

Hikaru Hashimoto ◽

Satoshi Sugino ◽

...

Keyword(s):

Risk Factors ◽

En Bloc Resection ◽

Bloc Resection ◽

Histopathological Diagnosis ◽

Single Centre ◽

En Bloc ◽

Cold Snare Polypectomy ◽

Serrated Lesions ◽

Snare Polypectomy

Background and aim Cold snare polypectomy (CSP) is growing in popularity due to its safety and convenience. Its indication is benign tumours such as adenoma and sessile serrated lesions (SSLs) <10 mm in size. CSP for SSLs ≥10 mm in size has not been well examined. In this study, we aimed the feasibility of this treatment regarding therapeutic results and local recurrence. Methods This was a single-centre retrospective cohort study. We reviewed SSLs with or without dysplasia of 10–20 mm that were resected by CSP from 2014 to 2020. All tumours were diagnosed endoscopically as SSLs without dysplasia before CSP with the help of magnifying narrow band imaging or blue laser imaging. We analysed the lesion characteristics, en bloc resection, histopathological diagnosis, adverse events and local recurrence. We analysed risk factors for recurrence, comparing recurrent lesions to non-recurrent lesions. We also compared risk factors for lesions 10–14 mm in size to those for lesions 15–20 mm in size. Results We analysed 160 lesions in 100 patients ( Mage± SD=67.7±10.1 years). The polyp size ( M± SD) was 11.8±2.8 mm, and the en bloc resection rate was 60.0% (96 cases). The rates of massive perioperative haemorrhage, postoperative haemorrhage and perforation were 1.3%, 0% and 0%, respectively. Regarding histopathological diagnosis, two (1.2%) cases showed SSLs with high-grade dysplasia. The recurrence rate in 101 lesions with a median follow-up period of 18 months (interquartile range 12–24 months) was 5.0%. There were no significant risk factors such as tumour size, location, morphology and so on in terms of recurrence. All recurrent cases could be resected by repeat CSP. The recurrence rates of lesions 10–14 mm in size and 15–20 mm in size were 4.7% and 6.3%, respectively ( p=0.713). Conclusion CSP of SSLs ≥10 mm in size according to magnifying endoscopic diagnosis was safe and promising, but the rate of recurrence was slightly high, meaning that close follow-up is required.

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