Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan.
Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan.
Acta Gastroenterol Belg. 2021 Jul-Sep;84(3):411-415. doi: 10.51821/84.3.008.
Cold snare polypectomy (CSP) is not recommended for the resection of pedunculated colorectal polyp. The aim of this study was to examine the adequacy of CSP compared to hot snare polypectomy (HSP) for the complete resection of pedunculated polyps with heads ≤ 1 cm in diameter.
This was a retrospective study of a cohort of consecutive outpatients who had resection of pedunculated polyps with heads 6-10 mm in diameter using either dedicated CSP or HSP from 2014 through 2019. The primary outcome measure was occurrence of delayed bleeding. Secondary outcome measures included total procedure time, en bloc resection rate, immediate bleeding, and number of clips used.
415 patients with 444 eligible polyps were enrolled; the CSP group (363 patients; 386 polyps) and HSP group (52 patients; 58 polyps). Patient characteristics, polyp characteristics and en bloc resection rate were similar between groups. The mean total procedure time and mean number (range) of hemostatic clips/ patient used were significantly lower with CSP than with HSP (18± 8 min vs. 25± 9 min, P<0.001; 1.1 ± 0.6 (1-3) vs.3.1 ± 1.6 (1-5), respectively, P<0.001). Delayed bleeding occurred significantly less frequently in the CSP, 0% (0/363 vs.3.8% (2/52) in the HSP group (P<0.001), although immediate bleeding was significantly higher in CSP than HSP (84% (325/386) vs. 12% (7/58), P<0.001).
Pedunculated colorectal polyps with heads ≤ 1 cm can be removed using CSP, which has several advantages over HSP.
冷圈套息肉切除术（CSP）不推荐用于切除有蒂结直肠息肉。本研究旨在比较 CSP 与热圈套息肉切除术（HSP）切除直径≤1cm 有蒂息肉的完全切除效果。
这是一项回顾性队列研究，纳入了 2014 年至 2019 年间使用专用 CSP 或 HSP 切除直径 6-10mm 有蒂息肉的连续门诊患者。主要结局测量指标为迟发性出血的发生情况。次要结局测量指标包括总手术时间、整块切除率、即刻出血和使用的夹数量。
共纳入 415 例患者，共 444 个可切除息肉；CSP 组（363 例；386 个息肉）和 HSP 组（52 例；58 个息肉）。两组患者特征、息肉特征和整块切除率相似。CSP 组的平均总手术时间和平均止血夹数量（范围）/患者明显低于 HSP 组（18±8min 比 25±9min，P<0.001；1.1±0.6（1-3）比 3.1±1.6（1-5），P<0.001）。CSP 组迟发性出血的发生率明显低于 HSP 组（0%（0/363）比 3.8%（2/52），P<0.001），而 CSP 组即刻出血的发生率明显高于 HSP 组（84%（325/386）比 12%（7/58），P<0.001）。
直径≤1cm 的有蒂结直肠息肉可以使用 CSP 切除，其与 HSP 相比具有多个优势。
