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Adoption of Optimal Small (6-9 mm) Colorectal Polyp Resection Technique Over Time.

Larissa Muething1,2, Bill Quach1,2, Derek E Smith3

  • 1Department of Medicine, Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

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Summary

Cold snare polypectomy (CSP) is the preferred method for removing small polyps, showing increased use from 2012 to 2019. Variations in technique adoption highlight the need for standardized guidelines.

Keywords:
Biopsy forcepsColonoscopyColorectal cancerColorectal polypsElectrocauteryPolypectomySnare

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Area of Science:

  • Gastroenterology
  • Endoscopic Procedures
  • Polyp Resection Techniques

Background:

  • Cold snare polypectomy (CSP) is favored for small (6-9 mm) polyps due to lower incomplete resection rates than cold forceps polypectomy (CFP).
  • CSP offers an improved safety profile compared to hot snare polypectomy (HSP).

Purpose of the Study:

  • To detail the resection techniques employed for small (6-9 mm) polyps.
  • To identify factors associated with suboptimal polyp resection techniques.

Main Methods:

  • Retrospective cohort study of 773 colonoscopies with 1,360 small polyp removals (2012-2019).
  • Analysis of patient, provider, and procedure characteristics.
  • Univariate and multivariate regression analyses to identify factors linked to suboptimal techniques.

Main Results:

  • Cold snare polypectomy (CSP) was used for 82.5% of small polyps.
  • Surgeon specialty influenced CFP use; polyp location and morphology influenced HSP use.
  • A significant increase in CSP adoption was observed, from 30.4% in 2012 to 96.8% in 2019.

Conclusions:

  • Cold snare polypectomy (CSP) is the predominant technique for small polyp removal, with widespread adoption from 2012 to 2019.
  • Disparities in optimal technique implementation across specialties underscore the necessity for standardized guidelines and quality monitoring.