Cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps: a multicenter randomized controlled trial

被引：16

作者：

Kim, Min Ji ^{[1
]}

Na, Soo Young ^{[1
]}

Kim, Joon Sung ^{[1
]}

Choi, Hyun Ho ^{[2
]}

Kim, Dae Bum ^{[3
]}

Ji, Jeong-Seon ^{[1
]}

Kim, Byung-Wook ^{[1
]}

Choi, Hwang ^{[1
]}

机构：

[1] Catholic Univ Korea, Incheon St Marys Hosp, Coll Med, Dept Internal Med,Div Gastroenterol, Seoul, South Korea

[2] Catholic Univ Korea, Uijeongbu St Marys Hosp, Coll Med, Dept Internal Med,Div Gastroenterol, Seoul, South Korea

[3] Catholic Univ Korea, St Vincents Hosp, Coll Med, Dept Internal Med,Div Gastroenterol, Seoul, South Korea

来源：

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2023年 / 37卷 / 05期

关键词：

Colonic polyp; Endoscopic mucosal resection; Cold snare polypectomy; Endoscopy; SESSILE SERRATED POLYPS; HOT; COLONOSCOPY; LESIONS; SAFETY; EMR; MM;

D O I：

10.1007/s00464-023-09875-1

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BackgroundCold snare polypectomy (CSP) is recommended for the resection of small colorectal polyps. However, few studies have investigated the efficacy of cold endoscopic mucosal resection (cold EMR) for small polyps. Thus, the aim of this study was to investigate the efficacy and safety of cold EMR compared with CSP for small colorectal polyps.MethodsThis was a multicenter, randomized trial conducted in three tertiary centers from January 2018 to February 2021. Patients with polyps sized 6-10 mm were randomized to CSP or cold EMR group. After polypectomy, two additional biopsies were performed to assess the completeness of resection. The primary outcome was complete polyp resection rate. Secondary outcomes were total procedure time and rate of adverse events such as immediate bleeding, delayed bleeding, and perforation.ResultsA total of 444 polyps in 327 patients were assessed and randomly assigned to each group. Of those, 425 polyps were finally analyzed based on pathology results. The complete resection rate was not significantly different between cold EMR and CSP groups (91.9% vs 89.8%, p = 0.24). However, the total procedure time was significantly increased in cold EMR (87.6 s vs. 45.8 s, p < 0.001). The rate of polypectomy adverse events was not significantly different between the two groups. No patient had massive bleeding or perforation.ConclusionsThere was no difference in complete resection rate or adverse events between CSP and cold EMR. However, CSP reduced the total procedure time.

引用

页码：3789 / 3795

页数：7

共 23 条

[1] Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline [J].