Best Polypectomy Technique for Small and Diminutive Colorectal Polyps: A Systematic Review and Meta-Analysis

Tranquillini, Caio; Bernardo, Wanderley Marques; Brunaldi, Vítor Ottoboni; Moura, Eduardo Guimarães Hourneaux de; Marques, Sirlei Garcia

doi:10.1590/s0004-2803.201800000-79

Cited by 8 publications

(5 citation statements)

References 33 publications

(93 reference statements)

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“…However, there is some degree of variation in the resection rate among cold polypectomy techniques itself. CSP appears to be safer as well as more effective than standard capacity forceps in the management of small and diminutive polyps [4].…”

Section: Conclusion This Systematic Review With Only Limited Datamentioning

confidence: 94%

“…Incomplete resection rates (IRR) of 10 % to 15 % have been reported for standard capacity biopsy forceps, cold snare (CSP) and hot snare across polyps of all sizes [3]. Studies have demonstrated that the resection rates of these diminutive polyps by hot biopsy forceps are suboptimal compared to cold techniques [4]. However, there is some degree of variation in the resection rate among cold polypectomy techniques itself.…”

Section: Conclusion This Systematic Review With Only Limited Datamentioning

confidence: 99%

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Is jumbo biopsy forceps comparable to cold snare for diminutive colorectal polyps? – a meta-analysis

2021

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Background and study aims Diminutive colorectal polyps are increasingly being detected and it is not clear whether jumbo biopsy forceps (JBF) has comparable efficacy to that of cold snare polypectomy (CSP) for management of these lesions. Methods An electronic literature search was performed for studies comparing resection rates of JBF and CSP for diminutive polyps (≤ 5 mm). The primary outcome was incomplete resection rate (IRR). Secondary outcomes included failure of tissue retrieval and complication rates (post-polypectomy bleeding, perforation etc.). Leave-one-out analysis was performed to examine the disproportionate role of any of the studies. Meta-analysis outcomes and heterogeneity (I2) were computed using Comprehensive meta-analysis software. Results A total of 4 studies (3 randomized controlled trials and 1 retrospective study) with 407 patients and 569 total polyps (mean size of 3.62 mm) was included for analysis. IRR of JBF was slightly higher than that of CSP (10.2 % vs 7.2 %) but this was not statistically significantly different (Pooled OR 1.76; 95 % CI 0.94–3.28; I2 = 0). Leave-one-out analysis showed no significant difference in the pooled OR comparison either. Two of the 4 studies reported 0 % failure of tissue retrieval for JBF and 1 % and 4.3 % for CSP. There were no complications for either group from the 2 studies that reported this outcome. The quality of the included studies was moderate to high. Conclusions This systematic review with only limited data shows that JBF and CSP are not statistically different in completely removing diminutive polyps, although careful endoscopic assessment is needed to ensure complete removal of all polyp tissue.

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Section: Conclusion This Systematic Review With Only Limited Datamentioning

confidence: 94%

Section: Conclusion This Systematic Review With Only Limited Datamentioning

confidence: 99%

Is jumbo biopsy forceps comparable to cold snare for diminutive colorectal polyps? – a meta-analysis

2021

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“…There are no differences in the complete resection, adverse-event, or tissue retrieval rates between cold and hot techniques; however, the cold approach is preferred because it is time-saving. 156,157 Cold-snare techniques are preferred among the cold techniques because of their higher complete and enbloc resection rates. Cold-forceps polypectomy should be avoided because of the increased risk of incomplete resection, which ranges from 9% to 61%.…”

Section: Endoscopic Resectionmentioning

confidence: 99%

“…Cold‐snare polypectomy is recommended for diminutive (≦5 mm) and small lesions (6–9 mm). There are no differences in the complete resection, adverse‐event, or tissue retrieval rates between cold and hot techniques; however, the cold approach is preferred because it is time‐saving 156,157 . Cold‐snare techniques are preferred among the cold techniques because of their higher complete and en‐bloc resection rates.…”

Section: Risk Factorsmentioning

confidence: 99%

Interventional gastroenterology in oncology

Wadhwa

Patel

Grover

et al. 2022

CA A Cancer J Clinicians

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Cancer is one of the foremost health problems worldwide and is among the leading causes of death in the United States. Gastrointestinal tract cancers account for almost one third of the cancer‐related mortality globally, making it one of the deadliest groups of cancers. Early diagnosis and prompt management are key to preventing cancer‐related morbidity and mortality. With advancements in technology and endoscopic techniques, endoscopy has become the core in diagnosis and management of gastrointestinal tract cancers. In this extensive review, the authors discuss the role endoscopy plays in early detection, diagnosis, and management of esophageal, gastric, colorectal, pancreatic, ampullary, biliary tract, and small intestinal cancers.

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“…Despite of many techniques, non of the methods are ideal. Among them, cold snare polypectomy is the best polypectomy technique for resectioning small colorectal polyp [7].…”

Section: Introductionmentioning

confidence: 99%

Real-Time Polyp Detection, Localization and Segmentation in Colonoscopy Using Deep Learning

et al. 2021

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Computer-aided detection, localisation, and segmentation methods can help improve colonoscopy procedures. Even though many methods have been built to tackle automatic detection and segmentation of polyps, benchmarking of state-of-the-art methods still remains an open problem. This is due to the increasing number of researched computer-vision methods that can be applied to polyp datasets. Benchmarking of novel methods can provide a direction to the development of automated polyp detection and segmentation tasks. Furthermore, it ensures that the produced results in the community are reproducible and provide a fair comparison of developed methods. In this paper, we benchmark several recent state-of-the-art methods using Kvasir-SEG, an open-access dataset of colonoscopy images, for polyp detection, localisation, and segmentation evaluating both method accuracy and speed. Whilst, most methods in literature have competitive performance over accuracy, we show that YOLOv4 with a Darknet53 backbone and crossstage-partial connections achieved a better trade-off between an average precision of 0.8513 and mean IoU of 0.8025, and the fastest speed of 48 frames per second for the detection and localisation task. Likewise, the proposed ColonSegNet achieved a competitive dice coefficient of 0.8206 and the best average speed of 182.38 frames per second for the segmentation task. Our comprehensive comparison with various state-ofthe-art methods reveal the importance of benchmarking the deep learning methods for automated real-time polyp identification and delineations that can potentially transform current clinical practices and minimise miss-detection rates.

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Best Polypectomy Technique for Small and Diminutive Colorectal Polyps: A Systematic Review and Meta-Analysis

Cited by 8 publications

References 33 publications

Is jumbo biopsy forceps comparable to cold snare for diminutive colorectal polyps? – a meta-analysis

Is jumbo biopsy forceps comparable to cold snare for diminutive colorectal polyps? – a meta-analysis

Interventional gastroenterology in oncology

Real-Time Polyp Detection, Localization and Segmentation in Colonoscopy Using Deep Learning

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