Cold sub-mucosal injection versus traditional cold snare polypectomy for diminutive and small colorectal polyps: A systematic review and meta-analysis.

IF 2 Q3 GASTROENTEROLOGY & HEPATOLOGY
Indian Journal of Gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-07-02 DOI:10.1007/s12664-024-01600-7
Yong-Cai Lv, Quan Dong, Yan-Hua Yao, Jing-Jing Lei
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引用次数: 0

Abstract

Background: The guidelines recommend conventional cold snare polypectomy (C-CSP) for diminutive and small colorectal polyps (≤ 10 mm). However, it remains unclear whether CSP with sub-mucosal injection (SI-CSP) achieves comparable efficacy to C-CSP for managing these lesions. This study compares SI-CSP with C-CSP for patients with diminutive and small colorectal polyps.

Methods: An electronic literature search was conducted to retrieve articles comparing resection outcomes between SI-CSP and C-CSP in diminutive and small colorectal polyps (registration number INPLASY2023100096). Our primary outcomes of interest were the complete resection rate (CRR), complications (namely immediate bleeding, delayed bleeding and perforation) and polypectomy time. Mean differences with 95% confidence intervals (CI) were employed for continuous variables, while odds ratios (OR) with 95% CI were calculated for categorical variables. Data was analyzed using a random effects model and the I2 test was utilized to assess heterogeneity.

Results: Eight studies involving 1470 patients with 2223 polyps were included in our analysis. The CRR was not significantly higher in the SI-CSP group, with an OR of 95% CI 0.50 (0.22, 1.15). The incidences of immediate bleeding (OR 95% CI 0.60 [0.26-1.40]) and delayed bleeding (OR 95% CI 0.88 [0.32-2.42]) did not differ significantly between the two groups. On average, the mean polypectomy time was 64.75 seconds shorter in the C-CSP group (95% CI, - 102.96 to - 26.53). Notably, no perforation events were reported in the included studies.

Conclusions: The use of SI-CSP was not superior to C-CSP in managing diminutive and small colorectal polyps and the procedure required significantly more time.

冷粘膜下注射与传统冷套法息肉切除术治疗微小结肠息肉:系统回顾和荟萃分析。
背景:指南推荐采用传统冷套法息肉切除术(C-CSP)治疗微小的结直肠息肉(≤ 10 毫米)。然而,在处理这些病变时,粘膜下注射冷息肉切除术(SI-CSP)是否能达到与 C-CSP 相媲美的疗效,目前仍不清楚。本研究比较了 SI-CSP 和 C-CSP 对微小结直肠息肉患者的治疗效果:我们进行了电子文献检索,以检索比较 SI-CSP 和 C-CSP 对微小和小型结直肠息肉切除效果的文章(注册号为 INPLASY2023100096)。我们关注的主要结果是完全切除率(CRR)、并发症(即即刻出血、延迟出血和穿孔)和息肉切除时间。连续变量采用平均差和 95% 置信区间 (CI),分类变量采用几率比 (OR) 和 95% 置信区间 (CI)。数据采用随机效应模型进行分析,并利用 I2 检验评估异质性:我们的分析共纳入了 8 项研究,涉及 1470 名患者和 2223 个息肉。SI-CSP组的CRR并无明显升高,OR值为95% CI 0.50 (0.22, 1.15)。两组间即刻出血(OR 95% CI 0.60 [0.26-1.40])和延迟出血(OR 95% CI 0.88 [0.32-2.42])的发生率无明显差异。平均而言,C-CSP 组的平均息肉切除时间缩短了 64.75 秒(95% CI,- 102.96 至 -26.53)。值得注意的是,纳入的研究均未报告穿孔事件:结论:SI-CSP 在治疗微小结直肠息肉方面并不优于 C-CSP,而且手术所需的时间明显更长。
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
Indian Journal of Gastroenterology
Indian Journal of Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
3.90
自引率
10.00%
发文量
73
期刊介绍: The Indian Journal of Gastroenterology aims to help doctors everywhere practise better medicine and to influence the debate on gastroenterology. To achieve these aims, we publish original scientific studies, state-of -the-art special articles, reports and papers commenting on the clinical, scientific and public health factors affecting aspects of gastroenterology. We shall be delighted to receive articles for publication in all of these categories and letters commenting on the contents of the Journal or on issues of interest to our readers.
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