Yasar Bulent, Kayadibi Huseyin, Abut Evren, Benek Dilek, Kochan Koray, Gonen Can
Department of Gastroenterohepatology, Camlica Erdem Hospital, Alemdag Yanyol Street, 34696, Üsküdar, Istanbul, Turkey,
Dig Dis Sci. 2015 Jan;60(1):217-25. doi: 10.1007/s10620-014-3320-2. Epub 2014 Aug 12.
Polypectomy with jumbo forceps (JF) and polypectomy with hot biopsy forceps (HBF) are still widely used techniques for removal of diminutive colorectal polyps (DCPs). JF may be more effective for the removal of DCPs because of their larger size.
To evaluate the histological quality and adequacy of DCPs resected using JF compared with HBF.
One hundred and seventy-nine patients with 237 DCPs were included in this study. DCPs were removed using either JP or HBF.
The tissue architecture was good in 29.9 % of the HBF group, in comparison with 90 % of the JF group (p < 0.001). No cautery damage or crash artifact was observed in 93.3 % of JF group and in 8.5 % of HBF group (p < 0.001). Moreover, there were statistically significant differences between the groups with regard to the high level of cautery damage or crush artifact (p < 0.001). The overall diagnostic quality of the specimens removed using JF was significantly better than that of the specimens removed by HBF (96 vs. 80 %, respectively, p < 0.001). There were statistically significant inverse associations between cautery damage or crush artifact and overall diagnostic quality of HBF and JF (r = -0.373, p < 0.001; r = -0.382, p < 0.001, respectively). Surgical margins were determined as negative in 87.5 % of the JF group and in 76.1 % of the HBF group (p = 0.022). A total of 80.8 % of the JF specimens and 30.8 % of the HBF specimens were well evaluated for two lateral and deep surgical margins (p < 0.001).
JF was superior to HBF for histopathological interpretation and eradication of DCPs.
使用大型活检钳（JF）进行息肉切除术和使用热活检钳（HBF）进行息肉切除术仍然是切除微小结直肠息肉（DCP）的广泛应用技术。由于JF尺寸较大，其在切除DCP方面可能更有效。
评估与HBF相比，使用JF切除的DCP的组织学质量和完整性。
本研究纳入了179例患有237个DCP的患者。使用JP或HBF切除DCP。
HBF组中29.9%的组织结构良好，而JF组为90%（p<0.001）。JF组93.3%和HBF组8.5%未观察到烧灼损伤或挤压伪像（p<0.001）。此外，两组在烧灼损伤或挤压伪像程度较高方面存在统计学显著差异（p<0.001）。使用JF切除的标本的总体诊断质量明显优于使用HBF切除的标本（分别为96%和80%，p<0.001）。烧灼损伤或挤压伪像与HBF和JF的总体诊断质量之间存在统计学显著的负相关（r=-0.373，p<0.001；r=-0.382，p<0.001）。JF组87.5%和HBF组76.1%的手术切缘判定为阴性（p=0.022）。总共80.8%的JF标本和30.8%的HBF标本对两侧和深部手术切缘进行了良好评估（p<0.001）。
在组织病理学解读和根除DCP方面，JF优于HBF。
