Gastroenterology, Omori Red Cross Hospital, Ota-ku, Japan.
Endoscopy. 2024 Jan;56(1):14-21. doi: 10.1055/a-2183-5505. Epub 2023 Sep 28.
Cold snare defect protrusions (CSDPs) that occur after cold snare polypectomy (CSP) are considered indicators of incomplete polyp resection (IPR). We have sometimes experienced difficulty resecting polyps with snaring alone; in such cases, a forcible pull on the snare by the endoscopist is necessary. We call this procedure "forced CSP (FCSP)." However, no previous studies have evaluated this procedure.
This was a prospective observational study. From November 2020 to June 2021, the frequency, safety, and validity of FCSP were evaluated at our hospital. We distinguished CSP with snaring alone performed by the assistant as conventional CSP, and CSP requiring a forcible pull on the snare by the endoscopist as FCSP.
Of 1315 polyps removed, 105 underwent FCSP (8%). The perforation rate was 0% in both groups. The rate of CSDP after the procedure was 96.2% (101/105) with FCSP and 6.4% (77/1210) with conventional CSP (<0.001). The rate of IPR was 12.5% (13/104) with FCSP and 6.2% (75/1208) with conventional CSP (=0.02). Multivariable analysis identified polyps located in the cecum (risk ratio [RR], 1.13; 95%CI 1.050-1.179; =0.003) and polyps ≥6mm in diameter (RR, 2.37; 95%CI 2.146-2.542; <0.001) as independent risk factors for FCSP.
FCSP was performed on 105 polyps (8%) in this study. FCSP may be associated with the occurrence of CSDP and IPR. Further studies are necessary to confirm our results.
冷圈套息肉切除术（CSP）后出现的冷圈套缺陷突出物（CSDP）被认为是息肉切除不完全（IPR）的指标。我们有时会遇到单独使用圈套器切除息肉有困难的情况；在这种情况下，内镜医师需要用力拉动圈套器。我们将此过程称为“强制 CSP（FCSP）”。然而，以前没有研究评估过这种方法。
这是一项前瞻性观察研究。从 2020 年 11 月至 2021 年 6 月，我们在我院评估了 FCSP 的频率、安全性和有效性。我们将由助手单独使用圈套器进行的 CSP 与需要内镜医师用力拉动圈套器的 CSP 区分开来。
在 1315 个切除的息肉中，有 105 个进行了 FCSP（8%）。两组的穿孔率均为 0%。进行该操作后 CSDP 的发生率为 FCSP 组 96.2%（101/105），常规 CSP 组 6.4%（77/1210）（<0.001）。FCSP 组 IPR 发生率为 12.5%（13/104），常规 CSP 组为 6.2%（75/1208）（=0.02）。多变量分析确定息肉位于盲肠（风险比 [RR]，1.13；95%CI 1.050-1.179；=0.003）和直径≥6mm 的息肉（RR，2.37；95%CI 2.146-2.542；<0.001）是 FCSP 的独立危险因素。
在这项研究中，对 105 个息肉（8%）进行了 FCSP。FCSP 可能与 CSDP 和 IPR 的发生有关。需要进一步的研究来证实我们的结果。
