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Endoscopy 2023; 55(12): 1083-1094
DOI: 10.1055/a-2129-5752
Systematic review

Cold snare endoscopic mucosal resection for colon polyps: a systematic review and meta-analysis

Mohamed Abdallah
1   Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, Minnesota, United States
,
Khalid Ahmed
2   Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United States
,
Daniyal Abbas
3   Department of Internal Medicine, East Carolina University, Greenville, North Carolina, United States
,
Mouhand F. H. Mohamed 
4   Brown University, Warren Alpert Medical School, Providence, Rhode Island, United States
,
Gaurav Suryawanshi
1   Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, Minnesota, United States
,
Nicholas McDonald
1   Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, Minnesota, United States
,
Natalie Wilson
1   Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, Minnesota, United States
,
Shifa Umar
5   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
Aasma Shaukat
6   Division of Gastroenterology, Department of Medicine and Population Health, NYU Grossman School of Medicine, New York, New York, United States
,
Mohammad Bilal
1   Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, Minnesota, United States
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Methodological issues in the evaluation of cold snare endoscopic mucosal resection for colon polypsEndoscopy 2024; 56(01): 79-79
DOI: 10.1055/a-2162-8583

Abstract

Background Cold snare endoscopic mucosal resection (CS-EMR) can reduce the risks associated with electrocautery during colon polyp resection. Data on efficacy are variable. This systematic review and meta-analysis aimed to estimate the pooled efficacy and safety rates of CS-EMR.

Methods We conducted a comprehensive literature search of multiple databases, from inception to March 2023, for studies addressing outcomes of CS-EMR for colon polyps. The weighted pooled estimates with 95 %CIs were calculated using the random effects model. I2 statistics were used to evaluate heterogeneity.

Results 4137 articles were reviewed, and 16 studies, including 2592 polyps in 1922 patients (51.4 % female), were included. Overall, 54.4 % of polyps were adenomas, 45 % were sessile serrated lesions (SSLs), and 0.6 % were invasive carcinomas. Polyp recurrence after CS-EMR was 6.7 % (95 %CI 2.4 %–17.4 %, I2  = 94 %). The recurrence rate was 12.3 % (95 %CI 3.4 %–35.7 %, I2  = 94 %) for polyps ≥ 20 mm, 17.1 % (95 %CI 4.6 %–46.7 %, I2  = 93 %) for adenomas, and 5.7 % (95 %CI 3.2 %–9.9 %, I2  = 50 %) for SSLs. The pooled intraprocedural bleeding rate was 2.6 % (95 %CI 1.5 %–4.5 %, I2  = 51 %), the delayed bleeding rate was 1.5 % (95 %CI 0.8 %–2.7 %, I2  = 18 %), and no perforations or post-polypectomy syndromes were reported, with estimated rates of 0.6 % (95 %CI 0.3 %–1.3 %, I2  = 0 %) and 0.6 % (95 %CI 0.3 %–1.4 %, I2  = 0 %), respectively.

Conclusion CS-EMR demonstrated an excellent safety profile for colon polyps, with variable recurrence rates based on polyp size and histology. Large prospective studies are needed to validate these findings.

Supplementary material



Publikationsverlauf

Eingereicht: 01. Februar 2023

Angenommen nach Revision: 14. Juli 2023

Accepted Manuscript online:
14. Juli 2023

Artikel online veröffentlicht:
22. September 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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