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Histopathologic features and fragmentation of polyps with cold snare defect protrusions
Tatsuya Ishii1, Taku Harada1, Tokuma Tanuma2
1Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan.
Gastrointestinal Endoscopy
|July 31, 2020
Summary
Cold snare defect protrusions (CSDPs) indicate polyp fragmentation during endoscopic resection. This study found CSDPs are linked to fragmented specimens and less muscularis mucosa on the polyp stump.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Pathology
Background:
- Cold snare defect protrusions (CSDPs) involve muscularis mucosa and submucosa.
- CSDPs are hypothesized to arise from specimen fragmentation during shallow excision.
Purpose of the Study:
- To determine if CSDPs are associated with polyp fragmentation during cold snare polypectomy.
- To identify risk factors for CSDP occurrence.
Main Methods:
- Retrospective analysis of 1026 neoplastic colorectal polyps resected via cold snare polypectomy.
- Assessment of CSDP presence from endoscopic images.
- Review of specimens for fragmentation and measurement of muscularis mucosa proportion on the stump.
Main Results:
- CSDPs were observed in 11.3% of polyps.
- Polyp fragmentation significantly correlated with CSDP occurrence (OR 3.74 univariate, OR 3.13 multivariate).
- Lower proportion of muscularis mucosa (>50%) was found in the CSDP group. Larger polyp and specimen size were associated with CSDPs.
Conclusions:
- CSDP occurrence is linked to less muscularis mucosa on the stump and specimen fragmentation.
- CSDPs serve as a reliable indicator of polyp fragmentation in clinical practice.
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