PROSPECTIVE RANDOMIZED CONTROLLED TRIAL OF TWO DIFFERENT WIRE TECHNIQUES FOR COLD SNARE POLYPECTOMY

Aims:

Cold snare polypectomy has shown its effectiveness for treatment of colorectal polyps and is increasingly being used. However, dedicated snares for cold snare polypectomy are still rare and no comparison of different wire techniques for this indication has yet been performed.

Primary objective of the study was to compare the efficacy of two different wire techniques (coiled wire versus monofilament) for cold-snare polypectomy in a prospective randomized controlled trial.

Methods:

Consecutive patients undergoing screening or surveillance colonoscopy were included. Once a polyp < 12 mm in size was detected, cold snaring was performed. Eligible polyps were randomized (1:1) to be treated with either monofilament or coiled wire technique. Primary endpoint was histologically confirmed en bloc resection rate. Second endpoints include complication rate (bleeding and perforation) and satisfaction rates of the endoscopist and assisting nurse.

Results:

Polyp size, histology and location did not significantly differ between the different groups. Mean size of lesions resected with coiled wire technique was 5.4 mm (Range 2 – 11 mm), with monofilament wire technique 5.2 mm (Range 2 – 10 mm), p = 0.7. The overall rates of en bloc resection were 100% for both wire techniques. Satisfaction rates of endoscopist and assisting nurse were not significantly different between both groups. Also cold-snare polypectomy was easy to perform for inexperienced endoscopists.

Conclusions:

Cold snare polypectomy is exceptional effective for resecting colorectal polyps. This prospective randomized trial shows for the first time that no differences between various wire techniques exist. Therefore, both coiled and monofilament wires can successfully being used for cold snare polypectomy.