Cold snare defect protrusion and incomplete polyp resection after forced cold snare polypectomy: a prospective...

Area of Science:

• Gastroenterology
• Endoscopic Surgery

Background:

• Cold snare defect protrusions (CSDPs) after cold snare polypectomy (CSP) indicate incomplete polyp resection (IPR).
• Difficult polyp resections sometimes require a forcible pull on the snare, termed forced CSP (FCSP).
• FCSP has not been previously evaluated.

Purpose of the Study:

• To evaluate the frequency, safety, and validity of FCSP.
• To compare FCSP with conventional CSP.

Main Methods:

• Prospective observational study from November 2020 to June 2021.
• Conventional CSP involved snaring alone; FCSP required a forcible pull by the endoscopist.
• Evaluated CSDP rates, IPR rates, and perforation rates.

Main Results:

• FCSP was used in 8% of 1315 polyp removals (105 cases).
• CSDP rates were significantly higher with FCSP (96.2%) than conventional CSP (6.4%).
• IPR rates were higher with FCSP (12.5%) versus conventional CSP (6.2%).
• Perforation rate was 0% for both techniques.
• Cecal location and polyps ≥6mm were risk factors for FCSP.

Conclusions:

• FCSP was performed in 8% of cases and may be associated with increased CSDP and IPR.
• Further research is needed to confirm these findings regarding FCSP efficacy and safety.