Comparison of complete resection rates in cold snare polypectomy using two different wire diameter snares: A...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Cold snare polypectomy (CSP) is a standard endoscopic procedure for removing small colorectal polyps.
• Optimizing CSP techniques is crucial for achieving complete histological resection and preventing polyp recurrence.

Purpose of the Study:

• To evaluate the impact of different snare wire diameters on the complete histological resection rate during CSP.
• To compare the resection depth and safety of conventional versus thin-wire snares in CSP.

Main Methods:

• A randomized controlled trial involving 254 colorectal polyps (≤10 mm) across two institutions.
• Polyps were randomized to CSP using either a normal-diameter (0.40 mm) or a thin-wire (0.23 mm) snare.
• The primary outcome was the histological complete resection rate.

Main Results:

• The thin-wire snare group achieved a significantly higher complete resection rate (81.0%) compared to the normal-diameter snare group (70.0%; P=0.04).
• Fewer unclear horizontal margin evaluations were noted in the thin-wire snare group (15.9% vs 28.1%; P=0.02).
• No significant differences were found in resection depth or specimen thickness between the groups.

Conclusions:

• CSP with a thin-wire snare enhances the ability to evaluate horizontal margins.
• The use of thin-wire snares increases the histological complete resection rate for small colorectal polyps.