Risk factors for incomplete polyp resection after cold snare polypectomy

Arimoto, Jun; Chiba, Hideyuki; Higurashi, Takuma; Fukui, Ryo; Tachikawa, Jun; Misawa, Noboru; Ashikari, Keiichi; Niikura, Toshihiro; Kuwabara, Hiromichi; Nakaoka, Michiko; Goto, Tetsuhiro; Nakajima, Atsushi

doi:10.1007/s00384-019-03347-6

Cited by 9 publications

(11 citation statements)

References 34 publications

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“…The horizontal margin was pathologically unknown in 33.6 % of formalin-fixed CSP specimens processed without pasting. Previous reports indicate that 18 % to 67 % of pathologically confirmed horizontal margins could not be evaluated after CSP [8][9][10][11][12]15], thus, our results are never too high. Unclear horizontal margin indicates that the presence or absence of an adenoma at the edge of the specimen cannot be diagnosed.…”

Section: Discussionmentioning

confidence: 45%

“…The advantages of CSP include shorter procedure time 3 4 and lower rates of postoperative abdominal symptoms 5 and post-bleeding events in patients on antithrombotic treatment 6 7 . However, because CSP does not burn for treatment, concerns remain regarding postoperative remnants 8 9 10 11 . Our results suggest that the pasting method utilized in the present study is inexpensive and can be done easily to improve the pathological evaluation of horizontal margins of specimens resected by CSP.…”

Section: Discussionmentioning

confidence: 99%

“…The risk factors for unclear horizontal margins were nonpasting group and lesions located in the right colon. Other studies have reported that risk factors for incomplete resection by CSP are female sex, descending colon, sigmoid colon, and trainee endoscopists [8,9,15]. We added these factors as secondary endpoints in our analysis, but the results were different ▶ ▶ Fig.…”

Section: Allmentioning

confidence: 98%

“…There have been some reports that pathological horizontal margin evaluation cannot be diagnosed in CSP specimens 8 9 10 11 12 . However, after resection of the tumor with CSP, there was almost no residual tumor 4 8 .…”

Section: Introductionmentioning

confidence: 99%

“…This procedure is characterized by shorter procedure times [3,4], less postoperative abdominal pain [5], and fewer post-bleeding events in patients on antithrombotic therapy [6,7] than EMR and HSP. Therefore, CSP has been widely performed in the last decade.There have been some reports that pathological horizontal margin evaluation cannot be diagnosed in CSP specimens [8][9][10][11][12]. However, after resection of the tumor with CSP, there was…”

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confidence: 99%

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Efficacy of specimen pasting after cold snare polypectomy for pathological evaluation of horizontal margins

et al. 2022

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Background and study aims Several studies have reported that pathological horizontal margin evaluation cannot be diagnosed in cold snare polypectomy (CSP) specimens. We conducted a prospective randomized controlled trial to determine the efficacy of pasting CSP specimens on paper for pathological horizontal margins. Patients and methods This was a single-center, prospective study conducted at Osaka Saiseikai Nakatsu Hospital. In this study, the indications for CSP were adenomas ≤ 10 mm. Colorectal polyps resected by CSP were randomized to the pasting and non-pasting groups after exclusion of fragmented specimens, and the extended CSP specimens pasted on paper were formalin-fixed in the pasting group. The primary endpoint was rate of unclear horizontal margins after CSP. Results A total of 216 CSP specimens were analyzed. The rate of unclear horizontal margins was significantly lower in the pasting group than in the non-pasting group (15.1 % vs 33.6 %, P = 0.002). CSP specimen pasting significantly reduced the rate of unclear horizontal margins. On multivariate analysis, non-pasting group (odds ratio [OR], 2.69; 95 % confidence interval [CI], 1.38–5.41; P = 0.003) and right colon (OR, 1.98; 95 %CI, 1.01–4.01; P = 0.047) were independent risk factors for unclear horizontal margins in CSP specimens. Conclusions Pasting the extended specimen is important for accurate pathological examination after CSP.

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