Efficacy and Safety of Cold Snare Polypectomy versus Cold Endoscopic Mucosal Resection for Resecting 3-10 mm Colorectal Polyps: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Digestion Pub Date : 2024-01-01 Epub Date: 2024-01-10 DOI:10.1159/000535521

Shao-Tong Wang, Qing-Zhou Kong, Yan-Qing Li, Rui Ji

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引用次数: 0

Abstract

Introduction: The safety and efficacy of cold snare polypectomy (CSP) compared to those of cold endoscopic mucosal resection (CEMR) have been reported. This meta-analysis compared the efficacy and safety of CEMR and CSP.

Methods: PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched to identify randomized controlled trials comparing the efficacy and safety of CEMR and CSP in removing 3-10 mm polyps. The outcomes assessed included complete resection rate, intraoperative bleeding rate, delayed bleeding rate, perforation, and polyp removal time. The results are reported as risk ratios (RR) and 95% confidence intervals (CIs) derived from a Mantel-Haenszel random-effects model.

Results: Seven studies comprising 1,911 polyps were included in the analysis. The complete resection rate of CEMR was comparable to that of CSP (RR: 1.01, 95% CI: 0.99-1.04, p = 0.32). Comparable results were also demonstrated for intraoperative bleeding rate (polyp-based analysis: RR: 1.22, 95% CI: 0.33-4.43, p = 0.77), delayed bleeding rate (polyp-based analysis: RR: 1.34, 95% CI: 0.44-4.15, p = 0.61), and polyp removal time (mean difference: 28.31 s, 95% CI: -21.40-78.02, p = 0.26). No studies reported cases of perforation.

Conclusion: CEMR has comparable efficacy and safety to CSP in removing 3-10 mm polyps. Further randomized controlled trials with long-term follow-up are warranted to compare and validate efficacy.

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冷吸息肉切除术与冷内镜粘膜切除术切除 3-10 毫米大肠息肉的有效性和安全性：随机对照试验的系统回顾和荟萃分析。

导言：有报道称，冷吸息肉切除术（CSP）与冷内镜粘膜切除术（CEMR）相比，安全性和有效性均有提高。本荟萃分析比较了 CEMR 和 CSP 的疗效和安全性。方法系统检索了 PubMed、EMBASE、Web of Science 和 Cochrane Library 数据库，以确定比较 CEMR 和 CSP 对切除 3-10 毫米息肉的有效性和安全性的随机对照试验。评估的结果包括完全切除率、术中出血率、延迟出血率、穿孔和息肉切除时间。结果以曼特尔-海恩泽尔随机效应模型得出的风险比 (RR) 和 95% 置信区间 (CI) 表示。结果共有七项研究纳入分析，共涉及 1,911 个息肉。CEMR的完全切除率与CSP相当（RR：1.01，95% CI：0.99-1.04，P = 0.32）。术中出血率（基于息肉的分析：RR：1.22，95% CI：0.33-4.43，P=0.77）、延迟出血率（基于息肉的分析：RR：1.34，95% CI：0.44-4.15，P=0.61）和息肉摘除时间（平均差异：28.31 秒，95% CI：-21.40~78.02，P=0.26）也显示了相似的结果。没有研究报告了穿孔病例。结论在切除 3-10 毫米息肉方面，CEMR 的疗效和安全性与 CSP 相当。有必要进一步开展长期随访的随机对照试验，以比较和验证疗效。

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

Digestion 医学-胃肠肝病学

CiteScore

7.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Digestion'' concentrates on clinical research reports: in addition to editorials and reviews, the journal features sections on Stomach/Esophagus, Bowel, Neuro-Gastroenterology, Liver/Bile, Pancreas, Metabolism/Nutrition and Gastrointestinal Oncology. Papers cover physiology in humans, metabolic studies and clinical work on the etiology, diagnosis, and therapy of human diseases. It is thus especially cut out for gastroenterologists employed in hospitals and outpatient units. Moreover, the journal''s coverage of studies on the metabolism and effects of therapeutic drugs carries considerable value for clinicians and investigators beyond the immediate field of gastroenterology.