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CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(07): E587-E594
DOI: 10.1055/s-0043-105578
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

Cold snare polypectomy reduced delayed postpolypectomy bleeding compared with conventional hot polypectomy: a propensity score-matching analysis

Takeshi Yamashina
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Manabu Fukuhara
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Takanori Maruo
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Gensho Tanke
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Saiko Marui
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Ryota Sada
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Mio Taki
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Yoshiaki Ohara
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Azusa Sakamoto
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Shinichiro Henmi
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Yugo Sawai
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Sumio Saito
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Norihiro Nishijima
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Akihiro Nasu
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Hideyuki Komekado
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Akira Sekikawa
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Masanori Asada
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Takehiko Tumura
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Ryuichi Kita
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Toru Kimura
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
,
Yukio Osaki
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
› Author Affiliations
Further Information

Publication History

submitted 21 August 2016

accepted after revision 10 February 2017

Publication Date:
23 June 2017 (online)

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Abstract

Background and study aims Cold snare polypectomy (CSP) for small colorectal polyps has lower incidence of adverse events, especially delayed postpolypectomy bleeding (DPPB). However, few data are available on comparisons of the incidence of DPPB of CSP and hot polypectomy (HP). The aim of this study was to evaluate the incidence of DPPB after CSP and compare it with that of HP. A propensity score model was used as a secondary analysis.

Patients and methods This was a retrospective cohort study conducted in a single municipal hospital. We identified 539 patients with colorectal polyps from 2 mm to 11 mm in size who underwent CSP (804 polyps in 330 patients) or HP (530 polyps in 209 patients) between July 2013 and June 2015.

Results There were no cases of DPPB in the CSP group. Conversely, DPPB occurred in 4 patients (1.9 %) after HP, resulting in a significant difference between the CSP and HP groups (0.008 % vs 0 %, P = 0.02). Propensity score-matching analysis created 402 matched pairs, yielding a significantly higher DPPB rate in the HP group than CSP group (0.02 % vs 0 %, P = 0.04). However, significantly more patients in the CSP group had unclear horizontal margins that precluded assessment (83 vs 38 cases, P < 0.001). The retrieval failure rate was significantly higher in the CSP group than in the HP group (3 % vs 0.7 %, P = 0.01).

Conclusions DPPB was less frequent with CSP than HP, as selected by the propensity score-matching model. Our findings indicate that CSP is recommended polypectomy in daily clinical setting. However, special care should be taken during polyp retrieval and horizontal margin assessment, and these issues could be taken into account in follow-up after CSP.

 

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