COLD SNARE POLYPECTOMY: A SAFE PROCEDURE FOR REMOVING SMALL NON-PEDUNCULATED COLORECTAL LESIONS.

Q2 Medicine

Arquivos de Gastroenterologia Pub Date : 2023-10-01 DOI:10.1590/S0004-2803.23042023-115

Carlos Eduardo Oliveira Dos Santos, Daniele Malaman, Ivan David Arciniegas Sanmartin, Ari Ben-Hur Stefani Leão, Isadora Zanotelli Bombassaro, Júlio Carlos Pereira-Lima

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引用次数: 0

Abstract

Background: Polypectomy is an important treatment option for preventing colorectal cancer. Incomplete polyp resection (IPR) is re-cognized as a risk factor for interval cancer.

Objective: The primary objective was to evaluate the complete polyp resection (CPR) rate for cold snare polypectomy (CSP) in small non-pedunculated polyps and, secondarily, specimen retrieval and complication rates.

Methods: We prospectively evaluated 479 polyps <10 mm removed by CSP in 276 patients by an inexperienced endoscopist.

Results: A total of 476 polyps (99.4%) were resected en bloc. A negative margin (classified as CPR) was observed in 435 polyps (90.8%). An unclear or positive margin (classified as IPR) was observed in 43 cases (9.0%) and 1 case (0.2%), respectively, for an overall IPR rate of 9.2% (44/479). The IPR rate was 12.2% in the first half of cases and 5.9% in the second half (P=0.02). Dividing into tertiles, the IPR rate was 15.0% in the first tertile, 6.9% in the second tertile, and 5.7% in the third tertile (P=0.01). Dividing into quartiles, the IPR rate was 15.8% in the first quartile and 5.9% in the fourth quartile (P=0.03). The IPR rate was 6.3% for type 0-IIa lesions and 14.1% for type 0-Is lesions (P=0.01). For serrated and adenomatous lesions, the IPR rate was 9.2%. Specimen retrieval failed in 3.6% of cases. Immediate bleeding (>30 s) occurred in 1 case (0.2%), treated with argon plasma coagulation. No delayed bleeding or perforation occurred.

Conclusion: CSP is a safe technique that provides good results for the resection of small non-pedunculated polyps, with a short learning curve.

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冷圈套息肉切除术:一个安全的程序，以消除小的非带梗结直肠病变。

背景:息肉切除术是预防结直肠癌的重要治疗选择。不完全息肉切除术(IPR)被认为是间期癌的危险因素。目的:主要目的是评估冷陷阱息肉切除术(CSP)治疗小的无带蒂息肉的完全息肉切除术(CPR)率，其次是标本回收和并发症发生率。方法:我们对479例息肉进行前瞻性评估。结果:共476例(99.4%)息肉被整组切除。435例息肉(90.8%)出现阴性边缘(归类为CPR)。在总体知识产权率为9.2%(44/479)的情况下，分别有43例(9.0%)和1例(0.2%)观察到不明确或阳性的边际(归类为知识产权)。知识产权率上半年为12.2%，下半年为5.9% (P=0.02)。分三类，第一、二、三三类的知识产权率分别为15.0%、6.9%和5.7% (P=0.01)。按四分位数划分，知识产权率第一四分位数为15.8%，第四四分位数为5.9% (P=0.03)。0-IIa型病变的IPR率为6.3%，0-Is型病变的IPR率为14.1% (P=0.01)。锯齿状和腺瘤状病变的IPR率为9.2%。标本采集失败率为3.6%。1例(0.2%)立即出血(> 30s)，经氩离子凝固治疗。未发生迟发性出血或穿孔。结论:CSP是一种安全的技术，治疗小型无带蒂息肉效果好，学习曲线短。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arquivos de Gastroenterologia Medicine-Gastroenterology

CiteScore

2.00

自引率

0.00%

发文量

109

审稿时长

9 weeks

期刊介绍： The journal Arquivos de Gastroenterologia (Archives of Gastroenterology), a quarterly journal, is the Official Publication of the Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia IBEPEGE (Brazilian Institute for Studies and Research in Gastroenterology), Colégio Brasileiro de Cirurgia Digestiva - CBCD (Brazilian College of Digestive Surgery) and of the Sociedade Brasileira de Motilidade Digestiva - SBMD (Brazilian Digestive Motility Society). It is dedicated to the publishing of scientific papers by national and foreign researchers who are in agreement with the aim of the journal as well as with its editorial policies.