A Comparison of Incomplete Resection Rate of Large and Small Colorectal Polyps by Cold Snare Polypectomy

Ma, Xianzong; Feng, Xiutang; Li, Yangjie; Du, Yongqiang; Wang, Jiheng; Wu, Yanmei; Jin, Hua; Xie, Xiaoli; Wang, Xin; Jin, Peng; Yang, Lang; Wang, Haihong; Leung, Joseph; Sheng, Jian-qiu; He, Yuqi

doi:10.1016/j.cgh.2021.11.010

Cited by 16 publications

(11 citation statements)

References 31 publications

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“…Nevertheless, the possibility of expanding the indication to nonpedunculated polyps larger than 10 mm by combining piecemeal resection is being investigated. Six prospective studies 37,50–54 evaluated the efficacy and safety of piecemeal CSP for larger (>10 mm) lesions. Kimoto et al ., 50 in a study of CSP outcomes for 474 sessile serrated lesions (SSL) larger than 10 mm (mean diameter, 14 mm), reported that 106 lesions (22%) were subjected to piecemeal resection with an IRR of only 0.2%.…”

Section: Possibility Of Expanding the Indication For Cspmentioning

confidence: 99%

“…Kimoto et al, 50 in a study of CSP outcomes for 474 sessile serrated lesions (SSL) larger than 10 mm (mean diameter, 14 mm), reported that 106 lesions (22%) were subjected to piecemeal resection with an IRR of only 0.2%. In an analysis of CSP outcomes of 440 colorectal polyps that measured 15 mm or smaller, Ma et al 53 reported that a risk factor that was associated with IRR was resection time (OR 7.39; 95% CI 1.48-36.96; P = 0.015), but lesion size was not. This report included 87 lesions (19.77%) with 10-15 mm polyps, but only five lesions (1.14%) were subjected to piecemeal resection and only one lesion (0.23%) was incompletely resected.…”

Section: Lesions Larger Than 10 MMmentioning

confidence: 99%

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Colorectal cold snare polypectomy: Current standard technique and future perspectives

Ishibashi

Suzuki

Nagai

et al. 2022

Digestive Endoscopy

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It has been shown that resection of adenomatous colorectal polyps can reduce mortality due to colorectal cancer. In daily clinical practice, simpler and safer methods of colorectal polypectomy have been sought to enable endoscopists to resect all detected lesions. Among these, cold snare polypectomy (CSP) is widely used in clinical practice because of its advantages in shortening procedure time, reducing delayed bleeding risk, and lowering treatment costs, while maintaining a similar complete resection rate for lesions smaller than 10 mm when compared to conventional hot snare polypectomy. This review introduces the findings of previous studies that investigated the efficacy and safety of the CSP procedure for nonpedunculated polyps smaller than 10 mm, and describes technical points to remember when practicing CSP based on the latest evidence, including using a thin wire snare specifically designed for CSP, and observing the surrounding mucosa of the resection site with chromoendoscopy or image‐enhanced endoscopy to ensure that there is no residual lesion. This review also describes the potential of expanding the indication of CSP as a treatment for lesions larger than 10 mm, those with pedunculated morphology, those located near the appendiceal orifice, and for patients under continuous antithrombotic agent therapy. Finally, the perspective on optimal treatments for recurrent lesions after CSP is also discussed, despite the limited related evidence and data.

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Section: Possibility Of Expanding the Indication For Cspmentioning

confidence: 99%

Section: Lesions Larger Than 10 MMmentioning

confidence: 99%

Colorectal cold snare polypectomy: Current standard technique and future perspectives

Ishibashi

Suzuki

Nagai

et al. 2022

Digestive Endoscopy

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“…In colonoscopy, accurate localization of lesions identified during a procedure is critical for guiding inspection in follow up procedures. Typically, polyp and CRC locations are reported by dividing the colon into segments, and recording the colon segment that includes each site [10] , [11] . The scale of colonoscopy’s localization problem is obvious during CRC tumor removal.…”

Section: Introductionmentioning

confidence: 99%

A Real-Time Endoscope Motion Tracker

Phillips

Armstrong

Fang

2022

IEEE J. Transl. Eng. Health Med.

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Objective: In colonoscopy, it is desirable to accurately localize the position of the endoscope's distal tip. Current tip localization techniques are not sufficient for recording the position and movement of the tip, nor is its rotation measured. We hypothesize that integration of multiple tracking modalities can effectively record the endoscope's motion in real time and continuously corrects cumulative errors. Methods: A dual modality tracking method is developed to measure the motion of the endoscope's insertion tube in real time, including insertion length, rotation angle, and their velocities. Optical trackballs were used to measure the endoscope insertion tube's motion and cameras were used to correct cumulative errors. Results: The accuracy of insertion length and rotational angle were measured. For speeds ≤ 10 mm/s, the median and 90 th percentile insertion position errors were 0.88 mm and 2.2 mm, respectively. The insertion position error increases with the speed, reaching a maximum of 10 mm for speeds < 40 mm/s. 11 • and 21 • were the median and 90 th percentile rotation angle errors for angular speeds < 40 • /s. Cumulative errors are sufficiently reduced by the imaging modality. Conclusion: The prototype device can precisely measure an unmodified endoscope's position, rotation, and motion in real time without significant accumulative error. The prototype device is small and compatible with existing commercial endoscopes as an add-on accessory, which could be used for reporting, localizing the lesions in follow up procedures, operational guidance, quality assurance, and training.INDEX TERMS Colonoscopy, endoscopes, medical devices, motion measurement, real-time systems. Clinical and Translational Impact Statement-This preclinical research develops an endoscope tracker that can be integrated into colonoscopy training, automatically record endoscope motion, and be further developed to improve polyp and tumor localization during colonoscopy.

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“…Ma et al reported the safety and efficacy of CSP for colorectal polyps, including SSLs, measuring between 5 and 15 mm and analyzed the factors influencing the IRR. 7 This was a prospective single-center observational study including the data of 440 colorectal neoplastic polyps. The primary outcome of IRR was determined by the presence of residual neoplasm in the biopsy sample obtained from the resection margin after CSP.…”

mentioning

confidence: 99%

“…Ma et al . reported the safety and efficacy of CSP for colorectal polyps, including SSLs, measuring between 5 and 15 mm and analyzed the factors influencing the IRR 7 . This was a prospective single‐center observational study including the data of 440 colorectal neoplastic polyps.…”

mentioning

confidence: 99%