Yamamoto Toshiki, Suzuki Sho, Kusano Chika, Yakabe Kyoko, Iwamoto Maho, Ikehara Hisatomo, Gotoda Takuji, Moriyama Mitsuhiko
Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo; Department of Gastroenterology, Yuri-Kumiai General Hospital, Akita, Japan.
Saudi J Gastroenterol. 2017 Jul-Aug;23(4):246-252. doi: 10.4103/sjg.SJG_598_16.
BACKGROUND/AIM: To compare the complete resection rate of hot and cold snare polypectomy for small colorectal polyps.
We retrospectively reviewed the medical records of 233 consecutive patients with 461 colorectal polyps up to 10 mm in diameter that were treated by hot or cold snare polypectomy between April 2014 and August 2016. Lesions treated by hot snare polypectomy (n = 137) and cold snare polypectomy (n = 324) were compared. The histological complete resection rates were evaluated between the two groups. We analyzed the relationship between factors for complete resection and clinical factors using multivariate analysis.
There was a significantly higher complete resection rate in hot snare polypectomy than in cold snare polypectomy (70.5% vs. 47.3%; P < 0.001). In the analysis of subgroups categorized according to polyp size, the complete resection rate for hot snare polypectomy was significantly higher than that for cold snare polypectomy among polyps ≥6 mm (69.0% vs. 43.5%; P < 0.001). Among polyps ≤5 mm, no significant difference regarding the complete resection rate was observed between the methods (81.3% vs. 53.4%; P = 0.057). There was no significant difference in the incidence of adverse events between the two groups. Multivariate analysis revealed that using hot snare polypectomy (odds ratio 3.03; P < 0.001), small lesion size (odds ratio 1.57; P = 0.049), and lesion location in the left colon (odds ratio 1.73; P = 0.007) were independent factors for complete resection.
Hot snare polypectomy provides a higher complete resection rate than does cold snare polypectomy for larger (6-10 mm) subcentimeter colorectal polyps.
背景/目的：比较热圈套与冷圈套息肉切除术治疗小的结直肠息肉的完整切除率。
我们回顾性分析了2014年4月至2016年8月期间连续接受热圈套或冷圈套息肉切除术治疗的233例患者的461枚直径达10mm的结直肠息肉的病历。比较热圈套息肉切除术治疗的病变（n = 137）与冷圈套息肉切除术治疗的病变（n = 324）。评估两组的组织学完整切除率。我们采用多因素分析方法分析完整切除相关因素与临床因素之间的关系。
热圈套息肉切除术的完整切除率显著高于冷圈套息肉切除术（70.5%对47.3%；P < 0.001）。在根据息肉大小分类的亚组分析中，直径≥6mm的息肉，热圈套息肉切除术的完整切除率显著高于冷圈套息肉切除术（69.0%对43.5%；P < 0.001）。直径≤5mm的息肉，两种方法的完整切除率无显著差异（81.3%对53.4%；P = 0.057）。两组不良事件发生率无显著差异。多因素分析显示，采用热圈套息肉切除术（比值比3.03；P < 0.001）、病变较小（比值比1.57；P = 0.049）以及病变位于左半结肠（比值比1.73；P = 0.007）是完整切除的独立因素。
对于较大（6 - 10mm）的亚厘米级结直肠息肉，热圈套息肉切除术比冷圈套息肉切除术具有更高的完整切除率。
