The Safety of Hot Biopsy Forceps in the Removal of Small Colonic Polyps

Mann, Nirmal S.; Mann, Surinder K; Alam, Intekhab

doi:10.1159/000007592

Cited by 35 publications

(12 citation statements)

References 10 publications

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“…However, it must be emphasized that too much coagulation on the muscularis propria should be avoided to prevent deep coagulation. This caution is similar as with the hemostatic forceps should be used[ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of forced coagulation with low high-frequency power setting during endoscopic submucosal dissection

Ishida¹,

Toyonaga²,

Ohara³

et al. 2017

WJG

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AIMTo investigated the hemostatic ability of the S and F1-10 methods in clinical and ex vivo studies.METHODSThe hemostatic abilities of the two methods were analyzed retrospectively in all six gastric endoscopic submucosal dissection cases. The treated vessel diameter, compressed vessel frequency, and bleeding frequency after cutting the vessels were noted by the recorded videos. The coagulation mechanism of the two power settings was evaluated using the data recording program and histological examination on macro- and microscopic levels in the ex vivo experiments using porcine tissues.RESULTSF1-10 method showed a significantly better hemostatic ability for vessels ≥ 2 mm in diameter and a trend of overall better coagulation effect, evaluated by the bleeding rate after cutting the vessels. F1-10 method could sustain electrical current longer and effectively coagulate the tissue wider and deeper than the S method in the porcine model.CONCLUSIONF1-10 method is suggested to achieve a stronger hemostatic effect than the S method in clinical procedures and ex vivo models.

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Section: Discussionmentioning

confidence: 99%

Efficacy of forced coagulation with low high-frequency power setting during endoscopic submucosal dissection

Ishida¹,

Toyonaga²,

Ohara³

et al. 2017

WJG

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“…According to different surveys, it seems that HBF is still a viable option that is preferred by 30%-50% of endoscopists[ 8 - 10 ]. The two studies, with the largest number of patients and polyps[ 11 , 12 ] showed no complications. The study by Wadas et al[ 13 ], which reports a 0.38% major bleeding rate and a 0.05% perforation rate, refers to a questionnaire-type survey from an era (1988) when the HBF technique was not standardized.…”

Section: To the Editormentioning

confidence: 99%

Should hot biopsy forceps be abandoned for polypectomy of diminutive colorectal polyps?

Panteris

Vezakis

Triantafillidis

2018

WJG

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Standardized approach to polypectomy of diminutive colorectal polyps (DCPs) is lacking since cold biopsy forceps have been associated with high levels of recurrence, hot biopsy forceps are considered inadequate and risky and cold snaring is currently under investigation for its efficacy and safety. This has led to confusion and a gap in clinical practice. This article discusses the usefulness and contemporary practical applicability of hot biopsy forceps and provides well-intentioned criticism of the new European guidelines for the treatment of DCPs. Diminutive colorectal polyps are a source of frustration for the endoscopist since their small size is accompanied by a considerable risk of premalignant neoplasia and a small but non-negligible risk of advanced neoplasia and even cancer. Since the proportion of diminutive colorectal polyps is substantial and exceeds that of larger polyps, their effective removal poses a considerable workload and a therapeutic challenge. During the last decade, the introduction of cold snaring to routine endoscopy practice has attempted to overcome the use of prior techniques, such as hot biopsy forceps. It is important to recognize that with the exception of endoscopic methods that are obviously unsafe and inadequate to serve their purpose, all other interventional endoscopic methods are operator-dependent in the sense that specific expertise and training are obligatory for the success of any therapeutic intervention. Since relevant publications on hot biopsy forceps are still in favor of its careful use, as it has not yet demonstrated inferiority compared with newer techniques, it would be prudent for any medical practitioner to evaluate the available tools and judge any new proposed technique based on the evidence before it is adopted.

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“…From 2 observational studies that included 288 cold snaring cases and 907 hot biopsy cases, no observations were made regarding complications such as perforation or significant bleeding 20,21. However, in a retrospective study that compared 436 cases of cold biopsy with 1,525 cases of hot biopsy, significant bleeding (0.39%) occurred in only 6 hot biopsy cases 22.…”

Section: Guidelines For Colonoscopic Polypectomymentioning

confidence: 99%

Korean Guideline for Colonoscopic Polypectomy

Lee¹,

Shin

Park

et al. 2012

Clin Endosc

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There is indirect evidence to suggest that 80% of colorectal cancers (CRC) develop from adenomatous polyps and that, on average, it takes 10 years for a small polyp to transform into invasive CRC. In multiple cohort studies, colonoscopic polypectomy has been shown to significantly reduce the expected incidence of CRC by 76% to 90%. Colonoscopic polypectomy is performed frequently in primary outpatient clinics and secondary and tertiary medical centers in Korea. However, there are no evidence-based, procedural guidelines for the appropriate performance of this procedure, including the technical aspects. For the guideline presented here, PubMed, Medline, and Cochrane Library literature searches were performed. When little or no data from well-designed prospective trials were available, an emphasis was placed on the results from large series and reports from recognized experts. Thus, these guidelines for colonoscopic polypectomy are based on a critical review of the available data as well as expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data become available. This guideline is intended to be an educational device to provide information that may assist endoscopists in providing care to patients. This guideline is not a rule and should not be construed as a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions for any particular case involve a complex analysis of the patient's condition and the available courses of action.

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The Safety of Hot Biopsy Forceps in the Removal of Small Colonic Polyps

Cited by 35 publications

References 10 publications

Efficacy of forced coagulation with low high-frequency power setting during endoscopic submucosal dissection

Efficacy of forced coagulation with low high-frequency power setting during endoscopic submucosal dissection

Should hot biopsy forceps be abandoned for polypectomy of diminutive colorectal polyps?

Korean Guideline for Colonoscopic Polypectomy

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