Colonoscopic snare polypectomy: analysis of 1485 resections comparing two types of current

Gossum, A. Van; Cozzoli, A.; Adler, Michaël; Taton, Gérard; Cremer, Michel

doi:10.1016/s0016-5107(92)70479-9

Cited by 176 publications

(90 citation statements)

References 8 publications

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“…With respect to procedure-related variables, several prior studies have suggested that the electrosurgical current applied, in particular, the cutting current, increases the risk of IPPB (14,15). Importantly, we found that polypectomy performed with a cutting current was strongly associated with a sevenfold higher risk of IPPB, which is consistent with a prior study (14).…”

Section: Discussionsupporting

confidence: 91%

“…Importantly, we found that polypectomy performed with a cutting current was strongly associated with a sevenfold higher risk of IPPB, which is consistent with a prior study (14). These findings suggest that the application of a blended current, including the endo-cut mode, offers an important preventive strategy for IPPB, though further study is warranted to determine the relative contributions of various currents to polypectomy associated bleeding.…”

Section: Discussionsupporting

confidence: 90%

“…Several studies have suggested that patient-related factors (e.g., prior aspirin or anticoagulant use) (8)(9)(10), polyp-related characteristics, and procedure-related factors such as the type of electrosurgical current or submucosal injection solution (11) may confer a high risk for PPB (12)(13)(14)(15)(16)(17). Although it has been suggested that patient-related, polyp-related, and procedure-related factors are strongly associated with PPB, few studies have evaluated the potential risk factors for immediate PPB (IPPB) in patients with colorectal polyp, and compared the identified risk factors of patients with and without IPPB, or examined potential risk factors by multivariate analysis.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Immediate Postpolypectomy Bleeding of the Colon: A Multicenter Study

et al. 2006

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OBJECTIVES: The aims of this prospective study were to document the incidence of colon immediate postpolypectomy bleeding (IPPB) according to grade, and to identify potential risk factors of IPPB in patients who have received complete colonoscopy and polypectomy because of a colorectal polyp. METHODS:This was a prospective, cross-sectional study of 5,152 patients treated at 11 tertiary medical centers between July 2003 and July 2004. Patient-related, polyp-related, and procedure-related variables were evaluated as potential risk factors for IPPB. IPPB was defined as a bleeding occurring during the procedure and was graded as G1-G4. Risk factors associated with IPPB were analyzed by univariate and multivariate logistic regression analysis. RESULTS:A total of 9,336 colonic polyps were removed in 5,152 patients, and 262 (2.8%) colorectal polyps in 215 patients presented with IPPB. Polyp-based multivariate analysis revealed that old age (≥65 yr), comorbid cardiovascular or chronic renal disease, anticoagulant use, polyp size greater than 1 cm, gross morphology of polyps such as pedunculated polyp or laterally spreading tumor, poorer bowel preparation, cutting mode of the electrosurgical current, and the inadvertent cutting of a polyp before current application were significant risk factors for IPPB.CONCLUSION: Nine factors have been found to be associated with IPPB and polypectomy should be undertaken with caution under these conditions.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Immediate Postpolypectomy Bleeding of the Colon: A Multicenter Study

et al. 2006

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“…The purpose of electrocauter in snare polypectomy is to either provide extra power in cutting the tissue or prevent bleeding by coagulation of the tissue (4). However, with this method, there can be perforations, immediate hemorrhage, and delayed post-polypectomy hemorrhage (7). We wanted to determine which method has better outcomes for small colorectal polyps.…”

Section: Introductionmentioning

confidence: 99%

Cold snare polypectomy versus hot snare polypectomy in endoscopic treatment of small polyps

Aslan

Camcı²,

Alper³

et al. 2014

Turk J Gastroenterol

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Background/Aims: The removal of small colon polyps by hot snare polypectomy (HP) is a commonly used method. Polypectomy with a cold snare (CP) has been increasingly utilized in recent years. Each method has its own advantages and disadvantages. Herein, we explored the efficacy and safety of each method. Materials and Methods: Between January 1, 2012 and June 30, 2012, 97 consecutive patients with small colorectal polyps ranging from 5-9 mm in size were separated into either the CP or HP group. Demographic data, the duration of polypectomy, and pathology reports were recorded. Results: Seventy-seven polyps were removed from 49 patients in the CP group, and 71 polyps were removed from 48 patients in the HP group. There was no significant difference between the groups with respect to gender, age distribution, number of polyps, or indications for colonoscopy. The mean polyp size was 7.21±1.4 mm in the CP group and 7.56±1.45 mm in the HP group (p=0.111). There was a significant difference in the mean procedure time between the two groups (CP, 25.71±4.3 sec; HP, 70.28±11.3 sec, p<0.001). One patient (1.3/1.4%) from each group developed post-polypectomy bleeding that required treatment. Histological evaluation revealed that 10 of the polyps (6.75%) were advanced adenomas. Pathological examination showed that the polyps were not completely removed in 4 patients (5.13%) in the CP group and 4 patients (5.63%) in the HP group (p=0.89). Conclusion: CP is an effective and safe method that shortens the polypectomy duration in small polyps (≤9 mm) compared to HP.

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“…However, the application of electrocautery in snare polypectomy has not yet been standardized due to a lack of large controlled trials. Surveys of endoscopists from different countries have shown that more than 80% use hot snare polypectomy for polyps between 7 and 9 mm (26,36,37). However, cold snare polypectomy has emerged as a safe and effective method for removing polyps up to 9 mm in size in recent prospective studies (32,38).…”

Section: Hot Snare Polypectomymentioning

confidence: 99%

Approaching polyps in the time of discrimination

Furnari¹

2015

rghn

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SummaryColorectal cancer (CRC) is one of the leading causes of cancer related death in the western countries. Up to 80% of CRC develops from adenomatous polyps, which can be detected and removed during colonoscopy, thus reducing the incidence of colorectal cancer. Screening colonoscopy is indeed the most efficient method of CRC prevention. However, "polyp" is an umbrella term including different type of lesions, which in turn are associated with different risks of developing or already harbouring neoplastic tissue. Several characteristics of a polyp can be assessed during an endoscopy examination such as gross morphology, superficial glandular pattern, vascular pattern and appearance under chromoendoscopy, which can reflect the nature of the polyp whether benign or with malignant potential. Nowadays, the umbrella term "polyectomy" has become obsolete as endoscopist should be able to tailor the management of colonic polyps according to their endoscopic features.

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Colonoscopic snare polypectomy: analysis of 1485 resections comparing two types of current

Cited by 176 publications

References 8 publications

Risk Factors for Immediate Postpolypectomy Bleeding of the Colon: A Multicenter Study

Risk Factors for Immediate Postpolypectomy Bleeding of the Colon: A Multicenter Study

Cold snare polypectomy versus hot snare polypectomy in endoscopic treatment of small polyps

Approaching polyps in the time of discrimination

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