Mucosal defect size predicts the adequacy of resection of ≤10 mm nonpedunculated colorectal polyps using a new cold snare polypectomy technique

Objectives There is still room for improvement in the methods used to achieve complete polyp resection. The aim of this study was to develop a cold snare polypectomy technique that will reliably result in resections containing the muscularis mucosae and the lateral polyp margins. Materials and methods Nonpedunculated polyps <= 10 mm were resected using a dedicated cold snare with the goal of creating a mucosal defect approximately 1 cm in dia. The completeness of resection of the lateral and vertical polyp margins was examined histologically. Results The cases of 201 patients (mean age 67 +/- 13 years; 115 men) with 500 eligible polyps were enrolled. The mean polyp size was 6.1 +/- 1.8 mm (range 1-10 mm). The mean mucosal defect size immediately after resection was 7.7 +/- 2.5 mm (range 3-15 mm). Overall, the complete resection rate in which the lateral and vertical margins were free from the neoplasia tissue was 92% (417/454, 95% CI, 89-94); in the remaining 8% of cases, the vertical margins showed complete resection but the lateral margins could not be evaluated due to the fragmentation of resected polyps. A mucosal defect >= 7 mm predicted complete resection of the mucosal layer containing the muscularis mucosae. Conclusion Complete mucosal layer resection of nonpedunculated colorectal polyps <= 10 mm was reliably achieved using a cold snare technique that produced a mucosal defect >= 7 mm in dia. Copyright (C) 2021 Wolters Kluwer Health, Inc. All rights reserved.