Open Access
CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(11): E1062-E1068
DOI: 10.1055/s-0043-113564
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

A prospective comparison of cold snare polypectomy using traditional or dedicated cold snares for the resection of small sessile colorectal polyps

Jeremy P. Dwyer
1   Department of Gastroenterology, Alfred Hospital, Monash University, Melbourne, Victoria, Australia 3004
,
Jonathan Y. C. Tan
1   Department of Gastroenterology, Alfred Hospital, Monash University, Melbourne, Victoria, Australia 3004
,
Paul Urquhart
1   Department of Gastroenterology, Alfred Hospital, Monash University, Melbourne, Victoria, Australia 3004
,
Robyn Secomb
1   Department of Gastroenterology, Alfred Hospital, Monash University, Melbourne, Victoria, Australia 3004
,
Catherine Bunn
1   Department of Gastroenterology, Alfred Hospital, Monash University, Melbourne, Victoria, Australia 3004
,
John Reynolds
2   Biostatistics, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia 3004
,
Richard La Nauze
1   Department of Gastroenterology, Alfred Hospital, Monash University, Melbourne, Victoria, Australia 3004
,
William Kemp
1   Department of Gastroenterology, Alfred Hospital, Monash University, Melbourne, Victoria, Australia 3004
,
Stuart Roberts
1   Department of Gastroenterology, Alfred Hospital, Monash University, Melbourne, Victoria, Australia 3004
,
Gregor Brown
1   Department of Gastroenterology, Alfred Hospital, Monash University, Melbourne, Victoria, Australia 3004
› Author Affiliations
Further Information

Publication History

submitted 02 October 2016

accepted after revision 22 May 2017

Publication Date:
27 October 2017 (online)

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Abstract

Background and study aims The evidence for efficacy and safety of cold snare polypectomy is limited. The aim of this study was to assess the completeness of resection and safety of cold snare polypectomy, using either traditional or dedicated cold snares.

Patients and methods This was a prospective, non-randomized study performed at a single tertiary hospital. Adult patients with at least one colorectal polyp (size ≤ 10 mm) removed by cold snare were included. In the first phase, all patients had polyps removed by traditional snare without diathermy. In the second phase, all patients had polyps removed by dedicated cold snare. Complete endoscopic resection was determined from histological examination of quadrantic polypectomy margin biopsies. Immediate or delayed bleeding within 2 weeks was recorded.

Results In total, 181 patients with 299 eligible polyps (n = 93 (173 polyps) traditional snare group, n = 88 (126 polyps) dedicated cold snare group) were included. Patient demographics and procedure indications were similar between groups. Mean polyp size was 6 mm in both groups (P = 0.25). Complete polyp resection was 165 /173 (95.4 %; 95 %CI 90.5 – 97.6 %) in the traditional snare group and 124/126 (98.4 %; 95 %CI 93.7 – 99.6 %) in the dedicated cold snare group (P = 0.16). Serrated polyps, compared with adenomatous polyps, had a higher rate of incomplete resection (7 % vs. 2 %, P = 0.03). There was no statistically significant difference in the rate of immediate bleeding (3 % vs. 1 %, P = 0.41) and there were no delayed hemorrhages or perforations.

Conclusions Cold snare polypectomy is effective and safe for the complete endoscopic resection of small (≤ 10 mm) colorectal polyps with either traditional or dedicated cold snares.