title: Feasibility of cold snare polypectomy in Japan: A pilot study.
abstract: OBJECTIVE
  To investigate the feasibility of cold snare polypectomy (CSP) in Japan.
  
  
  METHODS
  The outcomes of 234 non-pedunculated polyps smaller than 10 mm in 61 patients who underwent CSP in a Japanese referral center were retrospectively analyzed. The cold snare polypectomies were performed by nine endoscopists with no prior experience in CSP using an electrosurgical snare without electrocautery.
  
  
  RESULTS
  CSPs were completed for 232 of the 234 polyps. Two (0.9%) polyps could not be removed without electrocautery. Immediate postpolypectomy bleeding requiring endoscopic hemostasis occurred in eight lesions (3.4%; 95%CI: 1.1%-5.8%), but all were easily managed. The incidence of immediate bleeding after CSP for small polyps (6-9 mm) was significantly higher than that of diminutive polyps (≤ 5 mm; 15% vs 1%, respectively). Three (5%) patients complained of minor bleeding after the procedure but required no intervention. The incidence of delayed bleeding requiring endoscopic intervention was 0.0% (95%CI: 0.0%-1.7%). In total, 12% of the resected lesions could not be retrieved for pathological examination. Tumor involvement in the lateral margin could not be histologically assessed in 70 (40%) lesions.
  
  
  CONCLUSIONS
  CSP is feasible in Japan. However, immediate bleeding, retrieval failure and uncertain assessment of the lateral tumor margin should not be underestimated. Careful endoscopic diagnosis before and evaluation of the tumor residue after CSP are recommended when implementing CSP in Japan.
authors.affiliation: Yoji Takeuchi, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Kengo Nagai, Fumi Matsui, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Hiroyasu Iishi, Ryu Ishihara, Noriya Uedo, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Takeuchi
authors.affiliation: Yoji Takeuchi, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Kengo Nagai, Fumi Matsui, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Hiroyasu Iishi, Ryu Ishihara, Noriya Uedo, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamashina
authors.affiliation: Yoji Takeuchi, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Kengo Nagai, Fumi Matsui, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Hiroyasu Iishi, Ryu Ishihara, Noriya Uedo, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Matsuura
authors.affiliation: Yoji Takeuchi, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Kengo Nagai, Fumi Matsui, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Hiroyasu Iishi, Ryu Ishihara, Noriya Uedo, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ito
authors.affiliation: Yoji Takeuchi, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Kengo Nagai, Fumi Matsui, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Hiroyasu Iishi, Ryu Ishihara, Noriya Uedo, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Fujii
authors.affiliation: Yoji Takeuchi, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Kengo Nagai, Fumi Matsui, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Hiroyasu Iishi, Ryu Ishihara, Noriya Uedo, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Nagai
authors.affiliation: Yoji Takeuchi, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Kengo Nagai, Fumi Matsui, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Hiroyasu Iishi, Ryu Ishihara, Noriya Uedo, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Fumi
authors.initials: F
authors.lastname: Matsui
authors.affiliation: Yoji Takeuchi, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Kengo Nagai, Fumi Matsui, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Hiroyasu Iishi, Ryu Ishihara, Noriya Uedo, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Akasaka
authors.affiliation: Yoji Takeuchi, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Kengo Nagai, Fumi Matsui, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Hiroyasu Iishi, Ryu Ishihara, Noriya Uedo, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Hanaoka
authors.affiliation: Yoji Takeuchi, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Kengo Nagai, Fumi Matsui, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Hiroyasu Iishi, Ryu Ishihara, Noriya Uedo, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Higashino
authors.affiliation: Yoji Takeuchi, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Kengo Nagai, Fumi Matsui, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Hiroyasu Iishi, Ryu Ishihara, Noriya Uedo, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iishi
authors.affiliation: Yoji Takeuchi, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Kengo Nagai, Fumi Matsui, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Hiroyasu Iishi, Ryu Ishihara, Noriya Uedo, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Ryu
authors.initials: R
authors.lastname: Ishihara
authors.affiliation: Yoji Takeuchi, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Kengo Nagai, Fumi Matsui, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Hiroyasu Iishi, Ryu Ishihara, Noriya Uedo, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Henrik
authors.initials: H
authors.lastname: Thorlacius
authors.affiliation: Yoji Takeuchi, Takeshi Yamashina, Noriko Matsuura, Takashi Ito, Mototsugu Fujii, Kengo Nagai, Fumi Matsui, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Hiroyasu Iishi, Ryu Ishihara, Noriya Uedo, Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Noriya
authors.initials: N
authors.lastname: Uedo
keywords: Cold snare polypectomy; Colonoscopy; Colorectal neoplasm; Endoscopic gastrointestinal surgery; Polypectomy