Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan.
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.
Int J Colorectal Dis. 2020 May;35(5):859-867. doi: 10.1007/s00384-020-03547-5. Epub 2020 Feb 28.
Although cold snare polypectomy (CSP) has spread rapidly, it still remains controversial whether CSP is safe for pedunculated (Ip) polyps.
The aim of this study was to evaluate whether CSP for Ip polyps measuring less than 10 mm in diameter might be associated with an increased rate of delayed post-polypectomy bleeding (DPPB).
A total of 1641 colorectal polyps in 634 patients were resected at Omori Red Cross Hospital between April 2018 and December 2018. The polyps were divided into two groups depending on the morphology: the Ip group (90 polyps), and the non-Ip group (1551 polyps).
Among the 1641 polyps, there was no case of DPPB, including in the Ip group. Immediate bleeding occurred in a total of 101 (6.2%) cases. Polyp location in the rectum (OR (95% CI), 3.61 (1.843-7.092); p < 0.001), polyp diameter ≥ 6 mm (OR (95% CI), 2.65 (1.702-4.132); p < 0.001), Ip morphology (OR (95% CI), 15.66 (9.262-26.49); p < 0.001), and treatment with antithrombotic agents (OR (95% CI), 2.18 (1.358-3.501); p = 0.0012) were identified as significant risk factors for immediate bleeding.
This is the first study conducted to examine the safety of CSP for Ip polyps measuring less than 10 mm in diameter. CSP can be performed with a high level of safety even for Ip polyps. Based on our findings, we believe that Ip polyps could be included as an indication for CSP. However, prospective, randomized studies are necessary to confirm our results.
虽然冷圈套息肉切除术（CSP）已经迅速普及，但对于有蒂（Ip）息肉，CSP 是否安全仍然存在争议。
本研究旨在评估对于直径小于 10mm 的 Ip 息肉行 CSP 是否会增加迟发性息肉切除术后出血（DPPB）的发生率。
本研究回顾性分析了 2018 年 4 月至 2018 年 12 月期间在大森红十字医院接受治疗的 634 例患者的 1641 枚结直肠息肉。根据息肉形态将其分为两组：Ip 组（90 枚息肉）和非 Ip 组（1551 枚息肉）。
在 1641 枚息肉中，包括 Ip 组在内均未发生 DPPB。总的来说，共有 101 例（6.2%）发生即刻出血。直肠部位的息肉（OR（95%CI），3.61（1.843-7.092）；p<0.001）、息肉直径≥6mm（OR（95%CI），2.65（1.702-4.132）；p<0.001）、Ip 形态（OR（95%CI），15.66（9.262-26.49）；p<0.001）和使用抗血栓药物（OR（95%CI），2.18（1.358-3.501）；p=0.0012）是即刻出血的显著危险因素。
这是第一项评估直径小于 10mm 的 Ip 息肉行 CSP 安全性的研究。即使对于 Ip 息肉，CSP 也可以安全进行。基于我们的研究结果，我们认为可以将 Ip 息肉纳入 CSP 的适应证。然而，还需要前瞻性、随机对照研究来证实我们的结果。
