Prospective, randomized comparison of 2 methods of cold snare polypectomy for small colorectal polyps.
BACKGROUND
Both cold-only snare and hot polypectomy snare are used for the removal of small colorectal polyps.


OBJECTIVE
To compare the outcome of cold snare polypectomy of small colorectal polyps with a snare exclusively designed as a cold snare versus cold snare polypectomy by using a traditional polypectomy snare.


METHODS
Prospective, randomized, controlled study.


METHODS
Municipal hospital in Japan.


METHODS
Patients with colorectal polyps 10 mm or smaller in diameter were randomized to dedicated cold snare (dedicated cold snare group) or traditional cold snare (traditional cold snare group). The primary outcome measure was complete resection rates by cold snaring based on pathological examination. Secondary outcomes included bleeding within 2 weeks after polypectomy and identification of submucosal arteries and injured arteries in the resected specimens.


RESULTS
Seventy-six patients having 210 eligible polyps were randomized: dedicated cold snare group, N = 37 (98 polyps) and traditional cold snare group, N = 39 (112 polyps). Patient demographic characteristics including the number, size, and shape of the polyps removed were similar in the 2 groups. The complete resection rate was significantly greater with the dedicated cold than with the traditional cold snare (91% [89/98] vs 79% [88/112], P = .015), with a marked difference with 8- to 10-mm polyps, both flat and pedunculated. Immediate bleeding and hematochezia rates were similar (19% vs 21%, P = .86; 5.4% vs 7.7%, P = .69). No delayed bleeding occurred. Histology demonstrated a similar prevalence of arteries and injured arteries in the submucosa (33% [32/96] vs 30% [31/104], P = .59; 3.1% [3/96] vs 6.7% [7/104], P = .24).


CONCLUSIONS
Small sample size, single-center study.


CONCLUSIONS
Polypectomy by using a dedicated cold snare resulted in complete polyp removal more often than did cold snaring with a traditional snare, especially polyps 8 to 10 mm in diameter, whether flat or pedunculated. (


BACKGROUND
NCT02036047.)
Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan.
Akira
A
Horiuchi
Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan.
Kenji
K
Hosoi
Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan.
Masashi
M
Kajiyama
Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan.
Naoki
N
Tanaka
Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan.
Kenji
K
Sano
Department of Internal Medicine, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas, USA.
David Y
DY
Graham
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000295:instrumentation / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007417:Intestinal Polyps / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome