ArticleBMC gastroenterology2025
The efficacy and safety of cold snare polypectomy in intermediate nonpedunculated polyps.
Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCold snare polypectomy (CSP) is increasingly popular because of its safety and convenience, but it is currently recognized as the best way to remove diminutive polyps (≤ 5 mm). CSP for nonpedunculated polyps ≥ 10 mm in size has not been well examined. We evaluate the safety and efficacy of CSP for benign-looking intermediate nonpedunculated polyps.
methodsWe reviewed intermediate nonpedunculated polyps that resected by CSP from 2021 to 2023. The lesions were carefully observed with high-definition white-light (HD-WL) endoscopy and magnifying endoscopy with narrow-band imaging (ME-NBI) before CSP. We analyzed lesion characteristics, complete resection, cold snare defect protrusion (CSDP), histopathology, adverse events, and recurrence/residual. We compared the differences between lesions 10-14 mm in size and lesions ≥ 15 mm in size. We also analyzed risk factors for recurrence/residual and incomplete resection.
resultsWe retrospectively analyzed 631 lesions in 482 patients. The average size was 11.1 ± 1.3 mm, of which 3.3% were ≥ 15 mm. The CSDP rate was 34.1%. The rates of post-polypectomy bleeding (PPB), delayed post-polypectomy bleeding (DPPB), post-polypectomy perforation (PPP) and delayed post-polypectomy perforation (DPPP) were 0.3%, 0.2%, 0.0% and 0.0%, respectively. Two lesions were carcinoma in situ (0.3%) and seven lesions were high-grade dysplasia (HGD) (1.1%). The histological complete resection rate (the horizontal margin) was 94.3%. There were significant differences in sex, histological complete resection rate, and CSDP rate between lesions 10-14 mm in size and lesions ≥ 15 mm in size. CSDP was the only risk factor for incomplete resection of the polyps.
conclusionCSP of intermediate nonpedunculated polyps is safe and effective. The recurrence/residual rate and the adverse event rate were low.
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