Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan.
Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan.
Gastrointest Endosc. 2015 Oct;82(4):686-92. doi: 10.1016/j.gie.2015.02.012. Epub 2015 Apr 25.
Both cold-only snare and hot polypectomy snare are used for the removal of small colorectal polyps.
To compare the outcome of cold snare polypectomy of small colorectal polyps with a snare exclusively designed as a cold snare versus cold snare polypectomy by using a traditional polypectomy snare.
Prospective, randomized, controlled study.
Municipal hospital in Japan.
Patients with colorectal polyps 10 mm or smaller in diameter were randomized to dedicated cold snare (dedicated cold snare group) or traditional cold snare (traditional cold snare group). The primary outcome measure was complete resection rates by cold snaring based on pathological examination. Secondary outcomes included bleeding within 2 weeks after polypectomy and identification of submucosal arteries and injured arteries in the resected specimens.
Seventy-six patients having 210 eligible polyps were randomized: dedicated cold snare group, N = 37 (98 polyps) and traditional cold snare group, N = 39 (112 polyps). Patient demographic characteristics including the number, size, and shape of the polyps removed were similar in the 2 groups. The complete resection rate was significantly greater with the dedicated cold than with the traditional cold snare (91% [89/98] vs 79% [88/112], P = .015), with a marked difference with 8- to 10-mm polyps, both flat and pedunculated. Immediate bleeding and hematochezia rates were similar (19% vs 21%, P = .86; 5.4% vs 7.7%, P = .69). No delayed bleeding occurred. Histology demonstrated a similar prevalence of arteries and injured arteries in the submucosa (33% [32/96] vs 30% [31/104], P = .59; 3.1% [3/96] vs 6.7% [7/104], P = .24).
Small sample size, single-center study.
Polypectomy by using a dedicated cold snare resulted in complete polyp removal more often than did cold snaring with a traditional snare, especially polyps 8 to 10 mm in diameter, whether flat or pedunculated. (
NCT02036047.)
冷活检圈套器和热活检圈套器均可用于切除小型结直肠息肉。
比较专门设计的冷活检圈套器切除小型结直肠息肉与传统冷活检圈套器切除息肉的效果。
前瞻性、随机、对照研究。
日本市立医院。
患者的结直肠息肉直径为 10mm 或更小，随机分为专用冷活检圈套器（专用冷活检圈套器组）或传统冷活检圈套器（传统冷活检圈套器组）。主要观察指标为基于病理检查的冷活检完全切除率。次要结局包括息肉切除术后 2 周内出血以及在切除标本中识别黏膜下动脉和受损动脉。
76 例患者有 210 个符合条件的息肉，随机分为专用冷活检圈套器组（n = 37，98 个息肉）和传统冷活检圈套器组（n = 39，112 个息肉）。两组患者的人口统计学特征（包括切除息肉的数量、大小和形状）相似。专用冷活检圈套器的完全切除率显著高于传统冷活检圈套器（91%[89/98]比 79%[88/112]，P =.015），尤其是 8-10mm 的息肉，无论是平坦的还是带蒂的。即刻出血和血便的发生率相似（19%比 21%，P =.86；5.4%比 7.7%，P =.69）。无迟发性出血。组织学显示黏膜下动脉和受损动脉的发生率相似（33%[32/96]比 30%[31/104]，P =.59；3.1%[3/96]比 6.7%[7/104]，P =.24）。
样本量小，单中心研究。
与传统冷活检圈套器相比，专用冷活检圈套器切除息肉时更常能完整切除息肉，尤其是直径为 8-10mm 的息肉，无论是平坦的还是带蒂的。（临床试验注册号：NCT02036047。）
