Efficacy and Safety of Cold Snare Polypectomy in Intensive Downstaging Polypectomy for Colorectal Polyps in Patients with Familial Adenomatous Polyposis.

IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Digestion Pub Date : 2025-09-15 DOI:10.1159/000548434
Kazuki Ishibashi, Yuji Urabe, Takahiro Uda, Yukiko Sako, Tomoyuki Gurita, Satoshi Masuda, Yoshiki Hatsushika, Takeo Nakamura, Hirona Konishi, Akiyoshi Tsuboi, Hidenori Tanaka, Ken Yamashita, Yoshihiro Kishida, Yuichi Hiyama, Hidehiko Takigawa, Toshio Kuwai, Shiro Oka
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引用次数: 0

Abstract

Introduction: Intensive downstaging polypectomy (IDP) has emerged as an alternative strategy for managing colorectal polyps in patients with familial adenomatous polyposis (FAP), aiming to endoscopically control the disease in those who delay or refuse colectomy. This study evaluated the safety and efficacy of cold snare polypectomy (CSP) compared to hot snare polypectomy (HSP) and hot biopsy (HB) in patients with FAP undergoing IDP.

Methods: This retrospective study included patients diagnosed with FAP who underwent IDP between September 2012 and March 2024 at Hiroshima University Hospital. The patients were divided into two groups: CSP (October 2022 onward) and HOT (HSP and HB; 2012-2022). Outcomes assessed included adverse events, resection time per polyp, total procedure time, number of polyps removed per procedure, and R0 resection rate.

Results: A total of 185 treatment sessions were performed in 32 patients. The CSP group had a significantly shorter resection time per lesion and a higher number of polyps removed per procedure compared to the HOT group. The incidence of adverse events was significantly lower in the CSP group. Immediate bleeding occurred in 10 cases in the HOT group, while no such events were observed in the CSP group. Additionally, delayed bleeding and perforation were each observed in two cases in the HOT group, whereas neither event occurred in the CSP group.

Conclusion: CSP is a safe and efficacious method for polyp removal in patients with FAP undergoing IDP, offering shorter resection time and fewer adverse events compared to HSP and HB.

冷陷阱息肉切除术在家族性腺瘤性息肉病患者结肠直肠息肉强化降期切除术中的疗效和安全性。
强化下分期息肉切除术(IDP)已成为家族性腺瘤性息肉病(FAP)患者治疗结肠息肉的替代策略,旨在内镜下控制延迟或拒绝结肠切除术的患者的疾病。本研究评估了冷圈套息肉切除术(CSP)与热圈套息肉切除术(HSP)和热活检(HB)在FAP行IDP患者中的安全性和有效性。方法:本回顾性研究纳入了2012年9月至2024年3月期间在广岛大学医院接受IDP治疗的FAP患者。患者分为两组:CSP组(2022年10月起)和HOT组(HSP和HB; 2012-2022)。评估的结果包括不良事件、每个息肉切除时间、总手术时间、每次手术切除的息肉数量和R0切除率。结果:32例患者共进行185次治疗。与HOT组相比,CSP组每个病变的切除时间明显更短,每次手术切除的息肉数量也更多。CSP组不良事件发生率明显降低。HOT组有10例出现立即出血,而CSP组未出现立即出血。此外,HOT组中各有2例出现延迟出血和穿孔,而CSP组中均未发生。结论:与HSP和HB相比,CSP是一种安全有效的FAP行IDP的息肉切除方法,切除时间短,不良事件少。
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来源期刊
Digestion
Digestion 医学-胃肠肝病学
CiteScore
7.90
自引率
0.00%
发文量
39
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.
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