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Removal of diminutive colorectal polyps: A prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2017 Jan 14; Vol. 23 (2), pp. 328-335. - Publication Year :
- 2017
-
Abstract
- Aim: To compare the efficacy and safety of cold snare polypectomy (CSP) and hot forceps biopsy (HFB) for diminutive colorectal polyps.<br />Methods: This prospective, randomized single-center clinical trial included consecutive patients ≥ 20 years of age with diminutive colorectal polyps 3-5 mm from December 2014 to October 2015. The primary outcome measures were en-bloc resection (endoscopic evaluation) and complete resection rates (pathological evaluation). The secondary outcome measures were the immediate bleeding or immediate perforation rate after polypectomy, delayed bleeding or delayed perforation rate after polypectomy, use of clipping for bleeding or perforation, and polyp retrieval rate. Prophylactic clipping after polyp removal wasn't routinely performed.<br />Results: Two hundred eight patients were randomized into the CSP (102), HFB (106) and 283 polyps were evaluated (CSP: 148, HFB: 135). The en-bloc resection rate was significantly higher with CSP than with HFB [99.3% (147/148) vs 80.0% (108/135), P < 0.0001]. The complete resection rate was significantly higher with CSP than with HFB [80.4% (119/148) vs 47.4% (64/135), P < 0.0001]. The immediate bleeding rate was similar between the groups [8.6% (13/148) vs 8.1% (11/135), P = 1.000], and endoscopic hemostasis with hemoclips was successful in all cases. No cases of perforation or delayed bleeding occurred. The rate of severe tissue injury to the pathological specimen was higher HFB than CSP [52.6% (71/135) vs 1.3% (2/148), P < 0.0001]. Polyp retrieval failure was encountered CSP (7), HFB (2).<br />Conclusion: CSP is more effective than HFB for resecting diminutive polyps. Further long-term follow-up study is required.<br />Competing Interests: Conflict-of-interest statement: None to declare.
- Subjects :
- Aged
Biopsy instrumentation
Biopsy methods
Colonoscopy adverse effects
Colonoscopy instrumentation
Female
Follow-Up Studies
Hemostasis, Endoscopic instrumentation
Hemostasis, Endoscopic methods
Hot Temperature
Humans
Intestinal Perforation epidemiology
Intestinal Perforation etiology
Male
Microsurgery adverse effects
Microsurgery instrumentation
Middle Aged
Postoperative Hemorrhage epidemiology
Postoperative Hemorrhage etiology
Prospective Studies
Surgical Instruments
Treatment Outcome
Colonic Polyps surgery
Colonoscopy methods
Colorectal Neoplasms surgery
Microsurgery methods
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 23
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 28127206
- Full Text :
- https://doi.org/10.3748/wjg.v23.i2.328