COLD SNARE POLYPECTOMY: A SAFE PROCEDURE FOR REMOVING SMALL NON-PEDUNCULATED COLORECTAL LESIONS

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Polypectomy is crucial for colorectal cancer prevention.
• Incomplete polyp resection (IPR) is a significant risk factor for interval colorectal cancers.

Purpose of the Study:

• To assess the complete polyp resection (CPR) rate using cold snare polypectomy (CSP).
• To evaluate specimen retrieval and complication rates associated with CSP for small non-pedunculated polyps.

Main Methods:

• Prospective evaluation of 479 small non-pedunculated polyps (<10 mm) removed via CSP.
• Study conducted on 276 patients by an endoscopist with limited prior experience.

Main Results:

• A high en bloc resection rate of 99.4% (476/479 polyps) was achieved.
• The complete polyp resection (CPR) rate was 90.8% (435/479 polyps), with an overall incomplete polyp resection (IPR) rate of 9.2% (44/479).
• The IPR rate significantly decreased with experience, from 12.2% in the first half to 5.9% in the second half of cases (P=0.02).

Conclusions:

• Cold snare polypectomy (CSP) is a safe and effective method for resecting small non-pedunculated polyps.
• The technique shows a favorable learning curve, with decreasing IPR rates as experience is gained.
• CSP offers good results with low complication rates for this polyp type.