Details

Autor(en) / Beteiligte

• de Benito Sanz, Marina
• Hernández, Luis
• Garcia Martinez, María Isabel
• Diez-Redondo, Pilar
• Joao Matias, Diana
• Gonzalez-Santiago, Jesús M
• Ibáñez, Mercedes
• Núñez Rodríguez, María Henar
• Cimavilla, Marta
• Tafur, Carla
• Mata, Laura
• Guardiola-Arévalo, Antonio
• Feito, Jorge
• García-Alonso, Francisco Javier

Titel

Efficacy and safety of cold versus hot snare polypectomy for small (5-9 mm) colorectal polyps: a multicenter randomized controlled trial

Ist Teil von

• Endoscopy, 2022-01, Vol.54 (1), p.35-44

Ort / Verlag

Germany

Erscheinungsjahr

2022

Quelle

MEDLINE

Beschreibungen/Notizen

• Resection techniques for small polyps include cold snare polypectomy (CSP) and hot snare polypectomy (HSP). This study compared CSP and HSP in 5-9 mm polyps in terms of complete resection and adverse events. This was a multicenter, randomized trial conducted in seven Spanish centers between February and November 2019. Patients with ≥ 1 5-9 mm polyp were randomized to CSP or HSP, regardless of morphology or pit pattern. After polypectomy, two marginal biopsies were submitted to a pathologist who was blinded to polyp histology. Complete resection was defined as normal mucosa or burn artifacts in the biopsies. Abdominal pain was only assessed in patients without < 5 mm or > 9 mm polyps. 496 patients were randomized: 237 (394 polyps) to CSP and 259 (397 polyps) to HSP. Complete polypectomy rates were 92.5 % with CSP and 94.0 % with HSP (difference 1.5 %, 95 % confidence interval -1.9 % to 4.9 %). Intraprocedural bleeding occurred during three CSPs (0.8 %) and seven HSPs (1.8 %) (  = 0.34). One lesion per group (0.4 %) presented delayed hemorrhage. Post-colonoscopy abdominal pain presented similarly in both groups 1 hour after the procedure (CSP 18.8 % vs. HSP 18.4 %) but was higher in the HSP group after 5 hours (5.9 % vs. 16.5 %;  = 0.02). A higher proportion of patients were asymptomatic 24 hours after CSP than after HSP (97 % vs. 86.4 %;  = 0.01). We observed no differences in complete resection and bleeding rates between CSP and HSP. CSP reduced the intensity and duration of post-colonoscopy abdominal pain.