Efficacy and safety of cold versus hot snare polypectomy for resecting small colorectal polyps: Systematic review and meta‐analysis

Shinozaki, Satoshi; Kobayashi, Yasutoshi; Hayashi, Yoshikazu; Sakamoto, Hirotsugu; Lefor, Alan Kawarai; Yamamoto, Hironori

doi:10.1111/den.13173

Cited by 105 publications

(163 citation statements)

References 33 publications

(104 reference statements)

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“…Shinozaki ET AL . compared polyp retrieval rates and complete resection rates between cold and hot snare polypectomy as a main outcome measure of a meta‐analysis . Polyp retrieval rates have been included in eight studies, of which seven were included with regard to complete resection rates .…”

Section: Outcomes Of Cold Snare Polypectomymentioning

confidence: 99%

“…Polyp retrieval rates have been included in eight studies, of which seven were included with regard to complete resection rates . Cold snare polypectomy had a similar polyp retrieval rate compared with hot snare polypectomy (97% vs 97%, P = 0.60) with no heterogeneity . Three studies defined “complete resection” as a negative biopsy from the edge of the polypectomy site.…”

Section: Outcomes Of Cold Snare Polypectomymentioning

confidence: 99%

“…compared polyp retrieval rates and complete resection rates between cold and hot snare polypectomy as a main outcome measure of a metaanalysis. 24 Polyp retrieval rates have been included in eight studies, 6,7,9,10,25-28 of which seven were included with regard to complete resection rates. 6,7,9,[25][26][27][28] Cold snare polypectomy had a similar polyp retrieval rate compared with hot snare polypectomy (97% vs 97%, P = 0.60) with no heterogeneity.…”

Section: Outcomes Of Cold Snare Polypectomymentioning

confidence: 99%

“…6,7,9,[25][26][27][28] Cold snare polypectomy had a similar polyp retrieval rate compared with hot snare polypectomy (97% vs 97%, P = 0.60) with no heterogeneity. 24 Three studies 7,26,28 defined "complete resection" as a negative biopsy from the edge of the polypectomy site. The remaining four studies defined "complete resection" as en bloc resection with negative pathological margins (R0 resection rate).…”

Section: Outcomes Of Cold Snare Polypectomymentioning

confidence: 99%

“…Shinozaki et al also compared rates of delayed bleeding between cold snare polypectomy and hot snare polypectomy in their meta-analysis 24 of seven studies. 6,7,9,10,[26][27][28] Delayed bleeding occurred following hot snare polypectomy in only two of the seven studies.…”

Section: Delayed Bleeding or Perforationmentioning

confidence: 99%

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Cold snare polypectomy: Indications, devices, techniques, outcomes and future

Horiuchi

Ikuse

Tanaka

2019

Digestive Endoscopy

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Colonoscopy has been shown to reduce the risk of colon cancer by enabling the removal of precancerous lesions. Although cold snare and hot snare polypectomy have similar retrieval rates and complete resection rates, rates of delayed bleeding tend to be lower with cold snare polypectomy than with hot snare polypectomy, especially for patients taking antithrombotic agents. However, among cold snares there may be differences in terms of the completeness of polyp excision, as complete removal appears more likely with thin‐wire dedicated cold snares compared to the traditional, thick‐wire cold snares. Cold snare polypectomy may be especially well suited for use in patients taking antithrombotic agents, due to its minimal risk of delayed bleeding. Histological analyses suggest that cold snare polypectomy causes less damage to blood vessels in the submucosal layers, which results in a reduced incidence of hemorrhage compared to hot snare polypectomy. However, cold snare removal of small polyps may result in fragmentation of small specimens during collection and concerns as to whether the resection is complete. An endoscopy biomarker of effective cold snare polypectomy technique is needed to ensure complete removal of non‐pedunculated colorectal polyps ≤10 mm. Future uses of cold snare polypectomy may include piecemeal removal of sessile serrated adenoma/polyp lesions >10 mm. Currently, cold snare polypectomy should be considered a primary method for colorectal polyps of less than 10 mm, especially those in the 4‐ to 10‐mm range.

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Section: Outcomes Of Cold Snare Polypectomymentioning

confidence: 99%

Section: Outcomes Of Cold Snare Polypectomymentioning

confidence: 99%

Section: Outcomes Of Cold Snare Polypectomymentioning

confidence: 99%

Section: Outcomes Of Cold Snare Polypectomymentioning

confidence: 99%

Section: Delayed Bleeding or Perforationmentioning

confidence: 99%

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Cold snare polypectomy: Indications, devices, techniques, outcomes and future

Horiuchi

Ikuse

Tanaka

2019

Digestive Endoscopy

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Cold snare polypectomy for fundic gland polyps

Chen

Huang

Shin

2020

Adv in Digestive Medicine

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Fundic gland polyps (FGPs), the most common type of gastric polyps, are thought to be sporadic or associated with an inherited polyposis syndrome. FGPs associated with familial adenomatous polyposis (FAP) or attenuated FAP may have increased risk of dysplasia or malignancy. We evaluated the characteristics of FGPs and the endoscopic management with cold snare polypectomy of patients with fundic gland polyposis. We retrospectively analyzed data collected from our executive health management center on patients who underwent esophagogastroduodenoscopy and colonoscopy between January 2016 and December 2018. Patients with FGPs ≧10 were considered as having polyposis. All patients with FGPs received cold snare polypectomy or biopsy. Patients' age, gender, polyp size, polyp location, Helicobacter pylori infection status with rapid urease test, presence of gastroesophageal reflux disease (GERD), histological type of polyps and colonoscopy results were recorded. Major complications, such as bleeding or perforation events, were reviewed. FGPs were found in 86 patients (83.7% women). The mean age was 48.4 ± 9.6 years. Twenty‐six patients with FGPs were classified as having fundic gland polyposis. Most polyps were located at the body and the fundus. The polyp sizes were 3 to 8 mm. No Helicobater pylori infection was found. Eighteen (20.9%) patients with FGPs had GERD. In all, 26 (30.2%) patients with FGPs also had colon polyps, one with colon cancer (pTis). Histology revealed one case (1.1%) with focal low‐grade dysplasia. No complications, such as bleeding or perforation episode, were found. In further analysis between adults with FGPs and fundic gland polyposis, there were statistical significant differences in age (P = .01) and GERD (P = .018). In logistic regression of multivariate analysis for risk factors associated with fundic gland polyposis, age (aOR: 1.059, P = .041) and GERD (aOR: 3.638, P = .026) were risk factors for fundic gland polyposis. FGPs are common and benign gastric polyps, with a good prognosis. Management can be observation in sporadic FGPs. Endoscopic resection may be considered in selected patients with FGPs, especially those with fundic gland polyposis, or FGPs associated with FAP or attenuated FAP. We used cold snare polypectomy for patients with fundic gland polyposis, which provides easy and effective endoscopic management without complications.

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Large submucosal hematoma after cold snare polypectomy for colorectal adenoma

et al. 2022

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Cold snare polypectomy (CSP), for the treatment of colorectal polyps, has become widespread due to its low incidence of adverse events compared to that of endoscopic procedures such as endoscopic mucosal resection. However, we experienced a case of large hematoma development shortly after CSP for a colorectal adenoma despite no bleeding during the procedure. The patient underwent CSP for a 7‐mm type Isp lesion in the ascending colon. She returned the following day because of hematochezia. Computed tomography showed a 70‐mm, high‐intensity mass in the ascending colon, consistent with the large hematoma that was detected by colonoscopy. Although the patient initially had right‐sided abdominal pain, it gradually improved with conservative treatment. The hematoma decreased in size, and she was discharged 20 days after emergency admission. Although CSP can be a favorable alternative to more invasive procedures and is expected to be performed more frequently, adverse events, such as that described in this case, should be anticipated.

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Efficacy and safety of cold versus hot snare polypectomy for resecting small colorectal polyps: Systematic review and meta‐analysis

Abstract: This meta-analysis shows significantly shorter procedure time using CSP compared with HSP. CSP tends toward less delayed bleeding compared with HSP. We recommend CSP as the standard treatment for resecting small benign colorectal polyps.

Cited by 105 publications

References 33 publications

Cold snare polypectomy: Indications, devices, techniques, outcomes and future

Cold snare polypectomy: Indications, devices, techniques, outcomes and future

Cold snare polypectomy for fundic gland polyps

Large submucosal hematoma after cold snare polypectomy for colorectal adenoma

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