Repeat Cold Snare Polypectomy Can Be Performed for Recurrent Benign Lesions After Cold Snare Polypectomy

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Cancer Prevention

Background:

• Recurrence of polyps after cold snare polypectomy (CSP) can occur.
• Assessing the feasibility of repeat CSP for these recurrent lesions is crucial for effective management.
• Benign recurrent lesions up to 10 mm were the focus for repeat CSP.

Purpose of the Study:

• To evaluate the feasibility and clinical outcomes of repeat cold snare polypectomy (CSP) for recurrent colorectal polyps.
• To compare the outcomes of repeat CSP with standard CSP for non-recurrent lesions.
• To analyze the recurrence rates in both groups following endoscopic follow-up.

Main Methods:

• Retrospective review of 80 lesions treated with repeat CSP (2016-2021).
• Comparison with 454 non-recurrent lesions treated with standard CSP.
• Analysis included polyp size, morphology, histopathology, procedure time, resection rates, and complication rates.

Main Results:

• Repeat CSP was performed on lesions averaging 4.1 mm; common diagnoses included adenomas and sessile serrated lesions (SSLs).
• En bloc and complete histopathological resection rates were lower for repeat CSP (78.8%/43.8%) compared to standard CSP (98.0%/59.6%).
• Perioperative hemorrhage rates were comparable (1.3% vs 1.0%), with no postoperative complications in either group. Recurrence rates were similar (2.0% vs 0.7%).

Conclusions:

• Repeat cold snare polypectomy (CSP) is a safe and feasible endoscopic treatment for recurrent benign colorectal lesions.
• The study demonstrated comparable recurrence rates between repeat CSP and standard CSP.
• Repeat CSP offers an effective management option for polyp recurrence after initial CSP.