Tu1495 Cold SNARE Polypectomy With Pull Technique in Colonic Polyps From 7 up to 10 mm - a Porcine Model

Tribonias, George; Paraskeva, Konstantina; Komeda, Yoriaki; Bassioukas, Stefanos P.; Voudoukis, Evangelos; Giannikaki, Linda; Papalois, Apostolos; Paspatis, Gregorios A.

doi:10.1016/j.gie.2013.03.976

Cited by 5 publications

(6 citation statements)

References 4 publications

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“…The first author previously reported on an animal experiment conducted in pigs at another institution, and no perforation occurred with CSP for large polyps exceeding 1 cm[13]. In the present study, two polyps could not be resected with CSP because there was too much resistance during snaring; therefore, they were converted with conventional EMR using an injection and electrical current was used.…”

Section: Discussionmentioning

confidence: 77%

Removal of diminutive colorectal polyps: A prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy

Komeda¹,

Kashida²,

Sakurai³

et al. 2017

WJG

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AIMTo compare the efficacy and safety of cold snare polypectomy (CSP) and hot forceps biopsy (HFB) for diminutive colorectal polyps.METHODSThis 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.RESULTSTwo 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).CONCLUSIONCSP is more effective than HFB for resecting diminutive polyps. Further long-term follow-up study is required.

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Section: Discussionmentioning

confidence: 77%

Removal of diminutive colorectal polyps: A prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy

Komeda¹,

Kashida²,

Sakurai³

et al. 2017

WJG

Self Cite

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“…Prior studies, however, utilized CSP in small colorectal polyps, less than 1 cm in size and frequently less than 5 mm [ 9 ]. Animal study in a porcine model found CSP to be a safe and effective technique for flat colonic polyp removal up to 12 mm in size [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Cold Snare Polypectomy for Large Sessile Colonic Polyps: A Single-Center Experience

Muniraj

Sahakian

Ciarleglio³

et al. 2015

Gastroenterology Research and Practice

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Colonoscopic polypectomy has been shown to reduce the risk of colorectal cancer and the mortality. Postpolypectomy bleeding was reported to be lower with cold snare polypectomy (CSP) when compared with conventional polypectomy. CSP has traditionally been utilized only in smaller polyps below 1 cm. We retrospectively analyzed the CSP outcomes in patients with sessile polyps ≥10 mm in size and observed that CSP was feasible in large sessile polyps with no adverse events and with an acceptable rate of residual polyp on follow-up colonoscopy. Further prospective study in larger patient groups is warranted to determine optimal CSP techniques and whether CSP for large polyps has favorable efficacy in regard to complete polypectomy, procedure time, and complication rates relative to polypectomy with cautery.

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“… 8 Moreover, a previous report using the pig colon revealed that CSP with pull technique can resect mucosal layer, muscularis mucosa, and upper submucosal layer. 9 It is possible that the hematoma formed in the subserosal layer beyond the submucosa as shown on the CT scan after CSP. Although the submucosa or deeper layers were not included in the resection specimen in this case, and it is difficult to assess which layers were resected, the possibility cannot be ruled out that the CSP procedure may have disrupted the deeper vessels.…”

Section: Discussionmentioning

confidence: 99%

“…Although CSP is thought to cause little damage to the submucosal layer, a study of resected specimens indicated that approximately one quarter of samples included the submucosal layer 8 . Moreover, a previous report using the pig colon revealed that CSP with pull technique can resect mucosal layer, muscularis mucosa, and upper submucosal layer 9 . It is possible that the hematoma formed in the subserosal layer beyond the submucosa as shown on the CT scan after CSP.…”

Section: Discussionmentioning

confidence: 99%

Large submucosal hematoma after cold snare polypectomy for colorectal adenoma

et al. 2022

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Cold snare polypectomy (CSP), for the treatment of colorectal polyps, has become widespread due to its low incidence of adverse events compared to that of endoscopic procedures such as endoscopic mucosal resection. However, we experienced a case of large hematoma development shortly after CSP for a colorectal adenoma despite no bleeding during the procedure. The patient underwent CSP for a 7‐mm type Isp lesion in the ascending colon. She returned the following day because of hematochezia. Computed tomography showed a 70‐mm, high‐intensity mass in the ascending colon, consistent with the large hematoma that was detected by colonoscopy. Although the patient initially had right‐sided abdominal pain, it gradually improved with conservative treatment. The hematoma decreased in size, and she was discharged 20 days after emergency admission. Although CSP can be a favorable alternative to more invasive procedures and is expected to be performed more frequently, adverse events, such as that described in this case, should be anticipated.

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Tu1495 Cold SNARE Polypectomy With Pull Technique in Colonic Polyps From 7 up to 10 mm - a Porcine Model

Cited by 5 publications

References 4 publications

Removal of diminutive colorectal polyps: A prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy

Removal of diminutive colorectal polyps: A prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy

Cold Snare Polypectomy for Large Sessile Colonic Polyps: A Single-Center Experience

Large submucosal hematoma after cold snare polypectomy for colorectal adenoma

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