Evidence map›Paper›PMID 37332405›Full record

ArticleCureus2023

Submucosal Injection Using Epinephrine-Added Saline in Cold Snare Polypectomy for Colorectal Polyps Shortens Time Required for Resection: A Randomized Controlled Study.

Atsushi Katagiri, Norihiro Suzuki, Shinya Nakatani, Kazuo Kikuchi, Takahisa Fujiwara, Toshihiko Gocho, Kenichi Konda, Kazuya Inoki, Fuyuhiko Yamamura, Hitoshi Yoshida

Open access · diamondAbstract read
In one paragraph

Article in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Cold sub-mucosal injection versus traditional cold snare polypectomy for diminutive and small colorectal polyps: A systematic review and meta-analysis.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024
    Pooled it
  2. Pooled it
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Atsushi KatagiriDepartment of Medicine, Division of Gastroenterology, Showa University School of Medicine, Tokyo, JPN.
Norihiro SuzukiDepartment of Medicine, Division of Gastroenterology, Showa University School of Medicine, Tokyo, JPN.
Shinya NakataniDepartment of Medicine, Division of Gastroenterology, Showa University School of Medicine, Tokyo, JPN.
Kazuo KikuchiDepartment of Medicine, Division of Gastroenterology, Showa University School of Medicine, Tokyo, JPN.
Takahisa FujiwaraDepartment of Medicine, Division of Gastroenterology, Showa University School of Medicine, Tokyo, JPN.
Toshihiko GochoDepartment of Medicine, Division of Gastroenterology, Showa University School of Medicine, Tokyo, JPN.
Kenichi KondaDepartment of Medicine, Division of Gastroenterology, Showa University School of Medicine, Tokyo, JPN.
Kazuya InokiDepartment of Medicine, Division of Gastroenterology, Showa University School of Medicine, Tokyo, JPN.
Fuyuhiko YamamuraDepartment of Medicine, Division of Gastroenterology, Showa University School of Medicine, Tokyo, JPN.
Hitoshi YoshidaDepartment of Medicine, Division of Gastroenterology, Showa University School of Medicine, Tokyo, JPN.
Showa University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsImmediate bleeding after cold snare polypectomy (CSP) for colorectal polyps might interfere with confirmation of residuals and prolong the time required for resection. We investigated whether submucosal epinephrine-added saline injection reduces the time required for the CSP procedure.

methodsWe conducted a single-center, prospective, randomized controlled trial (clinical trial registration number: UMIN000046770). Patients with colorectal polyps ≤ 10 mm were randomly allocated to either CSP with epinephrine-added submucosal injection (CEMR group) or conventional CSP (CSP group). The primary outcome was the time required for resection defined as the time from the initiation of resection (the first insertion of the snare in the CSP group or the injection needle in the CEMR group) to the end of resection (confirming complete resection endoscopically after recognizing the cessation of immediate bleeding) in each lesion, and the secondary outcome was the time to spontaneous cessation of immediate bleeding after resection defined as the time from ensnaring the lesion to confirming the spontaneous cessation of immediate bleeding.

resultsA total of 126 patients were randomly assigned. Finally, 261 lesions in 118 patients (CEMR group, n = 59; CSP group, n = 59) were analyzed. The time required for resection calculated using the least-square mean was significantly shorter in the CEMR group (106.3 s, 95% CI 97.5 to 115.4 s) than in the CSP group (130.9 s, 95% CI 121.2 to 140.7 s) (P < 0.001). The time to spontaneous cessation of immediate bleeding was also significantly shorter in the CEMR group (20.4 s, 95% CI 14.3 to 26.5 s) than in the CSP group (74.2 s, 95% CI 67.6 to 80.7 s) (P < 0.001). Neither group had cases requiring hemostasis, perforation, or delayed bleeding.

conclusionsCEMR shortened the time for resection by shortening the time to cessation of immediate bleeding compared with conventional CSP in colorectal polyps ≤ 10 mm.

Indexed as

cold snare polypectomycolorectal polypimmediate bleedingrandomized controlled trialsubmucosal injection

Identifiers

PMID37332405
PMCPMC10276175
OpenAlexW4377024415

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.