Safety and efficacy of cold versus hot snare polypectomy including colorectal polyps ≥1 cm in size.
adverse effects
colonic neoplasms
colonic polyps
colonoscopic surgery
colonoscopy
Journal
Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
ISSN: 1443-1661
Titre abrégé: Dig Endosc
Pays: Australia
ID NLM: 9101419
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
revised:
26
07
2021
received:
09
06
2021
accepted:
28
07
2021
pubmed:
30
7
2021
medline:
21
1
2022
entrez:
29
7
2021
Statut:
ppublish
Résumé
Cold snare polypectomy (CSP; polypectomy without electrocautery) has spread rapidly worldwide during the past decade in what has been called "Cold Revolution". We performed a PubMed literature search for studies investigating CSP outcomes for colorectal polyps. Five randomized controlled trials (RCTs) assessed the complete resection rates (CRRs). The CRRs were similar regardless of the presence or absence of electrocautery, and the efficacy of submucosal injection for better CRRs is still controversial. Eight RCTs assessed the adverse events. The incidence of intraprocedural bleeding with cold procedures was comparable to or higher than that of hot procedures. The incidences of delayed bleeding were comparable to or lower with cold procedures, especially in patients taking anticoagulants. Fifteen studies have been reported on CSP for large (≥1 cm) colorectal polyps (10 retrospective studies, four prospective single-arm studies, and one prospective RCT). These studies reported that the safe cold procedures (a low intra- and post-procedural bleeding rate without perforation) could be implemented for lesions ≥1 cm. However, considering the incision depth of CSP and the local recurrence rate based on the current evidence, only large sessile serrated lesions (SSLs) can be candidates for cold procedures, and large adenomas should not be candidates for this procedure. Based on the current evidence, CSP seems to be the appropriate standard procedure for sub-centimeter colorectal low-grade adenomas due to its safety and simplicity. Thus, large SSLs can be candidates for cold procedures; however, careful inspection and further prospective studies are warranted to confirm the procedure's clinical relevance.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
274-283Subventions
Organisme : the Practical Research for Innovative Cancer Control from the Japan Agency for Medical Research and Development (AMED)
ID : JP 21ck0106556
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 Japan Gastroenterological Endoscopy Society.
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