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13.01.2022

Underwater versus conventional cold snare polypectomy of colorectal polyps 4–9 mm in diameter: a prospective randomized controlled trial

verfasst von: Yu Sik Myung, Hyuki Kwon, Jaeho Han, Jongreul Lim, Soo Yong Choi, Myong Ki Baeg, Sok Won Han

Erschienen in: Surgical Endoscopy | Ausgabe 9/2022

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Abstract

Background and aims

Cold snare polypectomy (CSP) has been reported as safe and effective method for the removal of small colorectal polyps. However, some studies showed low R0 resection rate. Underwater endoscopic mucosal resection is an effective technique to increase the proportions of complete resection. Therefore, the aim was to compare the rate of R0 resection of colorectal polyps 4–9 mm in diameter between conventional CSP (C-CSP) and underwater CSP (U-CSP).

Methods

This study was a prospective randomized controlled trial. A total of 198 polyps (4–9 mm) in 110 patients were enrolled between December 2019 and June 2020. The polyps were randomized to be treated with either C-CSP (100 polyps) or U-CSP (98 polyps).

Results

The R0 resection rate was significantly higher in U-CSP group than in C-CSP groups (84.7% vs. 59.0%; p < 0.001). The polyp retrieval rate of C-CSP and U-CSP was 94.5% and 100% (p = 0.030). The rate of polyp fragmentation of C-CSP and U-CSP group was 5.3% and 0% (p = 0.027). The resection time and retrieval time were longer in C-CSP than U-CSP (45.0 ± 37.7 s vs. 34.1 ± 21.2 s, p = 0.032 and 51.9 ± 67.7 s vs. 12.7 ± 12.4 s, p < 0.001). No clinically significant bleeding or perforation occurred in either group.

Conclusions

The results of this study were excellent with U-CSP of 4–9 mm colorectal polyps in terms of R0 resection, polyp retrieval and fragmentation rate, and procedure/retrieval time. Therefore, U-CSP is a safe and effective technique for removing colorectal polyps 4–9 mm in diameter. KCT (0004530).
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Metadaten
Titel
Underwater versus conventional cold snare polypectomy of colorectal polyps 4–9 mm in diameter: a prospective randomized controlled trial
verfasst von
Yu Sik Myung
Hyuki Kwon
Jaeho Han
Jongreul Lim
Soo Yong Choi
Myong Ki Baeg
Sok Won Han
Publikationsdatum
13.01.2022
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 9/2022
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-022-09013-3

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