A randomized comparison of cold snare polypectomy versus a suction pseudopolyp technique

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Medicine

Background:

• Cold snare techniques are standard for diminutive and small colorectal polyp removal.
• The comparative effectiveness of different polypectomy techniques is not well-established.
• This study investigates a novel suction pseudopolyp technique against standard cold snare polypectomy.

Purpose of the Study:

• To compare the completeness of excision between standard cold snare polypectomy and the suction pseudopolyp technique for colorectal polyps.
• To evaluate complication rates, including bleeding and perforation, associated with each technique.
• To assess polyp retrieval and histological excision completeness.

Main Methods:

• A single-center randomized study involving 112 patients.
• Patients were assigned to either standard cold snare polypectomy or the suction pseudopolyp technique.
• Primary outcome was endoscopic completeness of excision, with secondary outcomes including histological completeness, polyp retrieval, and complications.

Main Results:

• The suction pseudopolyp technique demonstrated a trend towards higher endoscopic completeness (98.6% vs. 92.6%) and histological completeness (76.3% vs. 63.8%), though not statistically significant.
• Polyp retrieval rates were similar between the two techniques (89.5% vs. 88.9%).
• No perforations or bleeding events requiring hemostasis were observed in either group.

Conclusions:

• Both standard cold snare polypectomy and the suction pseudopolyp technique are safe and effective for colorectal polyp removal.
• The suction pseudopolyp technique shows potential for improved excision completeness.
• Larger, multicenter trials are needed to confirm these findings and establish the superiority of the suction pseudopolyp technique.