Effects of Blended (Yellow) vs Forced Coagulation (Blue) Currents on Adverse Events, Complete Resection, or Polyp...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Electrosurgery

Background:

• Debate exists regarding optimal electrosurgical settings for colorectal polyp resection.
• Blended current (yellow) and coagulation current (blue) are commonly used settings.

Purpose of the Study:

• To compare the risk of adverse events and polyp recurrence between blended current (Endocut Q) and forced coagulation electrosurgical settings.
• To evaluate the impact of electrosurgical settings on complete resection rates for large colorectal polyps.

Main Methods:

• A single-blinded, randomized trial involving 928 patients undergoing endoscopic mucosal resection of large colorectal polyps (≥20 mm).
• Patients were assigned to either clip closure or no clip closure and to either Endocut Q or forced coagulation settings.
• Outcomes included severe adverse events, complete resection, and polyp recurrence at 30-day and 6-month follow-ups.

Main Results:

• No significant differences in severe adverse events (7.2% vs 7.9%) or polyp recurrence (17% vs 17%) between Endocut Q and forced coagulation groups.
• Complete resection rates were comparable (96% vs 95%).
• Immediate bleeding requiring intervention was higher in the Endocut group (17% vs 11%, P=.006).

Conclusions:

• Both Endocut Q and forced coagulation are effective and safe electrosurgical settings for large colorectal polyp resection.
• The choice of electrosurgical setting can be based on endoscopist expertise and preference.
• No significant difference in key outcomes supports flexibility in electrosurgical technique selection.