title: Diagnostic quality of: polyps resected by snare polypectomy: does the type of electrosurgical current used matter?
abstract: BACKGROUND
  Traditionally, snare polypectomy is performed using blended, coagulation, or pure cutting electrical current (EC). The aim of this study was to assess and compare the diagnostic quality of polyps obtained by snare polypectomy using two different electrosurgical currents.
  
  
  METHODS
  Consecutive patients undergoing colonoscopy underwent polypectomy using either blended EC with a conventional electrosurgical generator (ESG) or using an ESG with a microprocessor that automatically controls cutting and coagulation (Endocut). An experienced blinded gastrointestinal (GI) pathologist evaluated the specimens for diameter, cautery damage (amount and degree), margin evaluability, architecture, and general histologic diagnostic quality.
  
  
  RESULTS
  One hundred sixteen patients (69% men, mean age 63.8 +/- 15 yr) underwent 148 polypectomies (78 using blended current and 70 using Endocut). We found that the cautery degree was less with the Endocut than with the blended current (p < 0.02). Cautery amount was also higher in polyps resected using blended current (56%) than Endocut (51%) but this difference did not reach statistical significance (p= 0.1). Polyps resected using Endocut had better margin evaluability (75.7% to 60.3%, p= 0.046). The overall tissue architecture was similar in both groups. Polyps removed with blended current had less overall quality as compared to polyps removed by Endocut (p= 0.024).
  
  
  CONCLUSIONS
  More extensive tissue damage occurred using blended EC with the conventional ESG than when using Endocut. The quality of the polypectomy specimens was overall better using Endocut. Finally, the ability to evaluate resected polyp margins and overall tissue histology was better with the microprocessor-controlled ESG than with the conventional ESG.
authors.affiliation: Department of Medicine, Division of Gastroenterology and Hepatology, VA Medical Center Hospital and University of Alabama Hospital, University of Alabama, Birmingham, Alabama, USA.
authors.forename: Lucía C
authors.initials: LC
authors.lastname: Fry
authors.forename: Audrey J
authors.initials: AJ
authors.lastname: Lazenby
authors.forename: Irina
authors.initials: I
authors.lastname: Mikolaenko
authors.forename: Brent
authors.initials: B
authors.lastname: Barranco
authors.forename: Steffen
authors.initials: S
authors.lastname: Rickes
authors.forename: Klaus
authors.initials: K
authors.lastname: Mönkemüller
mesh_terms: D000368:Aged; D001706:Biopsy / Q000379:methods; D003111:Colonic Polyps / Q000473:pathology* / Q000601:surgery*; D003113:Colonoscopy; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results