Evaluation of cold snare polypectomy for small pedunculated (Ip) polyps with thin stalks: a prospective clinical feasibility study

Arimoto, Jun; Chiba, Hideyuki; Tachikawa, Jun; Yamaoka, Kenji; Yamazaki, Dai; Higa, Airi; Okada, Nagaya; Suto, Takuma; Kawano, Naoya; Niikura, Toshihiro; Kuwabara, Hiromichi; Nakaoka, Michiko; Ida, Tomonori; Morohashi, Taiki; Goto, Tetsuhiro

doi:10.1080/00365521.2021.1998603

Cited by 9 publications

(12 citation statements)

References 30 publications

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“…Diagnosis of the morphologic type was made in accordance with the Paris classification system [17,18]. With regard to morphologic types, we previously conducted three studies on the use of CSP for Ip polyps with thin stalks [20,21,22], and we also included CSP for Ip polyps with thin stalks in the current study. However, we did not perform CSP for Ip polyps with thick stalks or for polyps >10 mm in diameter.…”

Section: Resultsmentioning

confidence: 99%

Cold snare defect protrusion and incomplete polyp resection after forced cold snare polypectomy: a prospective observational study

Arimoto,

Chiba,

Yamada

et al. 2023

Endoscopy

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Background: Cold snare defect protrusions (CSDPs) that occur after cold snare polypectomy (CSP) are considered indicators of incomplete polyp resection (IPR). We have sometimes experienced difficult polyp resection with snaring alone; in such cases, a forcible pull on the snare by the endoscopist is necessary. We call this procedure “forced CSP (FCSP).” However, no previous studies have addressed this point. Methods: This is a prospective observational study (UMIN000041718). From November 2020 to June 2021, the frequency, safety, and validity of FCSP were evaluated at our hospital. We distinguished CSP with snaring alone performed by the assistant and CSP requiring a forcible pull on the snare by the endoscopist as conventional CSP (CCSP) and FCSP, respectively. Results: A total of 1315 polyps were removed. FCSP was performed on 105 polyps (8%, 105/1315). The perforation rate was 0% in both groups. The rate of CSDP after the procedure was 96.2% (101/105) and 6.4% (77/1210) in the FCSP and CCSP groups (p<0.001), respectively. The rate of IPR was 12.5% (13/104) and 6.2% (75/1208) in the FCSP and CCSP groups (p=0.0224), respectively. Multivariable analysis identified polyps located in the cecum (risk ratio (RR), 1.13; 95% confidence interval (CI)=1.050-1.179); p=0.003) and polyps ≥6 mm in diameter (RR, 2.37; 95%CI=2.146-2.542); p<0.001) as independent risk factors for FCSP. Conclusions: FCSP was performed on 105 polyps (8%) in this study. There is the possibility that FCSP is associated with the occurrence of CSDPs and IPR. Further studies are necessary in the future to confirm our results.

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Section: Resultsmentioning

confidence: 99%

Cold snare defect protrusion and incomplete polyp resection after forced cold snare polypectomy: a prospective observational study

Arimoto,

Chiba,

Yamada

et al. 2023

Endoscopy

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“…Six studies including 1025 patients (1111 polyps with a mean size 4 to 8.5 mm) were analyzed and included in the final study. [12][13][14][15][16][17] 116 and 995 polyps were removed with HSP and CSP, respectively. Details of patient characteristics, polyp location, size, and outcomes are further summarized in Tables 1, 2.…”

Section: Resultsmentioning

confidence: 99%

“…com/JCG/A957. Four studies were determined to be high quality [13][14][15]17 and 2 were moderate quality. 13,16 There were 2 prospective and 4 retrospective studies; 2 were multi-centered studies.…”

Section: Quality Assessmentmentioning

confidence: 99%

Cold Snare Polypectomy in Small (<10 mm) Pedunculated Colorectal Polyps

Canakis

Chandan

Bapaye

et al. 2023

Journal of Clinical Gastroenterology

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“…Several observational studies have shown the efficacy and safety of CSP for pedunculated polyps smaller than 10 mm 62–64 . Arimoto et al 65 . conducted a prospective study to evaluate the safety of CSP for polyps smaller than 10 mm with thin stalks.…”

Section: Possibility Of Expanding the Indication For Cspmentioning

confidence: 99%

“…Arimoto et al65 conducted a prospective study to evaluate the safety of CSP for polyps smaller than 10 mm with thin stalks. They reported that performing CSP for 114 lesions resulted in no case of delayed postpolypectomy bleeding.…”

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confidence: 99%

Colorectal cold snare polypectomy: Current standard technique and future perspectives

Ishibashi

Suzuki

Nagai

et al. 2022

Digestive Endoscopy

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It has been shown that resection of adenomatous colorectal polyps can reduce mortality due to colorectal cancer. In daily clinical practice, simpler and safer methods of colorectal polypectomy have been sought to enable endoscopists to resect all detected lesions. Among these, cold snare polypectomy (CSP) is widely used in clinical practice because of its advantages in shortening procedure time, reducing delayed bleeding risk, and lowering treatment costs, while maintaining a similar complete resection rate for lesions smaller than 10 mm when compared to conventional hot snare polypectomy. This review introduces the findings of previous studies that investigated the efficacy and safety of the CSP procedure for nonpedunculated polyps smaller than 10 mm, and describes technical points to remember when practicing CSP based on the latest evidence, including using a thin wire snare specifically designed for CSP, and observing the surrounding mucosa of the resection site with chromoendoscopy or image‐enhanced endoscopy to ensure that there is no residual lesion. This review also describes the potential of expanding the indication of CSP as a treatment for lesions larger than 10 mm, those with pedunculated morphology, those located near the appendiceal orifice, and for patients under continuous antithrombotic agent therapy. Finally, the perspective on optimal treatments for recurrent lesions after CSP is also discussed, despite the limited related evidence and data.

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Evaluation of cold snare polypectomy for small pedunculated (Ip) polyps with thin stalks: a prospective clinical feasibility study

Cited by 9 publications

References 30 publications

Cold snare defect protrusion and incomplete polyp resection after forced cold snare polypectomy: a prospective observational study

Cold snare defect protrusion and incomplete polyp resection after forced cold snare polypectomy: a prospective observational study

Cold Snare Polypectomy in Small (<10 mm) Pedunculated Colorectal Polyps

Colorectal cold snare polypectomy: Current standard technique and future perspectives

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