Efficacy and safety of cold-snare endoscopic mucosal resection for colorectal adenomas 10 to 14 mm in size: a prospective observational study

Yabuuchi, Yohei; Imai, Kenichiro; Ito, Sayo; Kishida, Yoshihiro; Yoshida, Masao; Kawata, Noboru; Kakushima, Naomi; Takizawa, Kohei; Ishiwatari, Hirotoshi; Matsubayashi, Hiroyuki; Aizawa, Daisuke; Oishi, Takuma; Imai, Toru; Ono, Hiroyuki

doi:10.1016/j.gie.2020.05.019

Cited by 26 publications

(33 citation statements)

References 34 publications

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“…The efficacy and safety of hot and cold snare EMR for non-pedunculated colorectal adenomas < 20 mm has been evaluated in few studies, which suggested a capacity for resectability improvement and for delivering better histopathological evaluation especially with the cold snare technique[ 15 , 67 - 69 ].…”

Section: Jnet Classificationmentioning

confidence: 99%

“…A Japanese prospective, observational study[ 69 ] assessing an overall 80 non-pedunculated adenomas measuring 10-14 mm and treated with cold snare EMR reported en bloc and R0 resection rates of 82.5% and 63.8%, respectively. No post-procedural adverse events occurred.…”

Section: Jnet Classificationmentioning

confidence: 99%

“…Among the studies evaluating EMR for colorectal lesions < 20 mm, the majority did not analyze the recurrence rates[ 67 - 69 ], but only one reported a 39.4% of recurrence at surveillance[ 15 ].…”

Section: Jnet Classificationmentioning

confidence: 99%

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Indications and outcomes of endoscopic resection for non-pedunculated colorectal lesions: A narrative review

Shahini¹,

Libânio²,

Secco³

et al. 2021

WJGE

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In the last years, endoscopic techniques gained a crucial role in the treatment of colorectal flat lesions. At the same time, the importance of a reliable assessment of such lesions to predict the malignancy and the depth of invasion of the colonic wall emerged. The current unsolved dilemma about the endoscopic excision techniques concerns the necessity of a reliable submucosal invasive cancer assessment system that can stratify the risk of the post-procedural need for surgery. Accordingly, this narrative literature review aims to compare the available diagnostic strategies in predicting malignancy and to give a guide about the best techniques to employ. We performed a literature search using electronic databases (MEDLINE/PubMed, EMBASE, and Cochrane Library). We collected all articles about endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) registering the outcomes. Moreover, we analyzed all meta-analyses comparing EMR vs ESD outcomes for colorectal sessile or non-polypoid lesions of any size, preoperatively estimated as non-invasive. Seven meta-analysis studies, mainly Eastern, were included in the analysis comparing 124 studies and overall 22954 patients who underwent EMR and ESD procedures. Of these, eighty-two were retrospective, twenty-four perspective, nine case-control, and six cohorts, while three were randomized clinical trials. A total of 18118 EMR and 10379 ESD were completed for a whole of 28497 colorectal sessile or non-polypoid lesions > 5-10 mm in size. In conclusion, it is crucial to enhance the preoperative diagnostic workup, especially in deciding the most suitable endoscopic method for radical resection of flat colorectal lesions at risk of underlying malignancy. Additionally, the ESD necessitates further improvement because of the excessively time-consuming as well as the intraprocedural technical hindrances and related complications. We found a higher rate of en bloc resections and R0 for ESD than EMR for non-pedunculated colorectal lesions. Nevertheless, despite the lower local recurrence rates, ESD had greater perforation rates and needed lengthier procedural times. The prevailing risk for additional surgery in ESD rather than EMR for complications or oncologic reasons is still uncertain.

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Section: Jnet Classificationmentioning

confidence: 99%

Section: Jnet Classificationmentioning

confidence: 99%

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Indications and outcomes of endoscopic resection for non-pedunculated colorectal lesions: A narrative review

Shahini¹,

Libânio²,

Secco³

et al. 2021

WJGE

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“…There have been several reports on CSP for lesions larger than 10 mm in recent years, but these studies do not adequately consider histological factors such as HGD and cancer. 10 Therefore, this dedicated snare may be the key to opening the door to a new world that supports these next CSP possibilities. Let us examine what happens in the future.…”

mentioning

confidence: 99%

“…If CSP using this dedicated snare can resect deeper layers than CSP using conventional snares, it may exceed the limitations of conventional CSP and expand the indications for conventional lesions. There have been several reports on CSP for lesions larger than 10 mm in recent years, but these studies do not adequately consider histological factors such as HGD and cancer [ 10 ]. Therefore, this dedicated snare may be the key to opening the door to a new world that supports these next CSP possibilities.…”

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confidence: 99%

Big Issues on Small Polyps: An Ideal Device, But Is It for an Ideal Indication?

Takeuchi

2021

Clin Endosc

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Colorectal cancer (CRC) is the third most common cancer in men and the second most common cancer in women worldwide. 1 Colonoscopy plays an essential role in the prevention of the development of CRC and death. 2 Most polyps identified at colonoscopy do not cause harm to patients. In most cases, the adenoma-carcinoma sequence progresses slowly. However, the malignant potential of individual polyps is unknown, and even small/diminutive polyps can occasionally harbor cancer. Therefore, all polyps (even diminutive rectal polyps) should be removed. Although colorectal polypectomy has few adverse events, post-polypectomy bleeding and perforation pose a serious risk to the patient. Owing to the prophylactic nature of most polypectomies, the risk-benefit ratio is not well balanced should an adverse event occur after the procedure. Cold snare polypectomy (CSP), a polypectomy method that does not use electrocautery, has rapidly gained popularity in recent years because of its safety. 3 Since CSP does not involve electrocautery, the risk of residual polyps has been a concern-that it would increase residual polyps compared to conventional resection methods. Matsuura et al. reported that additional endoscopic mucosal resection COMMENTARY

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Cold Snare Resection of Colorectal Polyps: Updates and Recent Developments

Djinbachian¹,

Renteln²

2022

Curr Treat Options Gastro

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Efficacy and safety of cold-snare endoscopic mucosal resection for colorectal adenomas 10 to 14 mm in size: a prospective observational study

Cited by 26 publications

References 34 publications

Indications and outcomes of endoscopic resection for non-pedunculated colorectal lesions: A narrative review

Indications and outcomes of endoscopic resection for non-pedunculated colorectal lesions: A narrative review

Big Issues on Small Polyps: An Ideal Device, But Is It for an Ideal Indication?

Cold Snare Resection of Colorectal Polyps: Updates and Recent Developments

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