Hirose Ryohei, Yoshida Takuma, Yoshida Naohisa, Bandou Risa, Ikegaya Hiroshi, Nakaya Takaaki, Itoh Yoshito
Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
Department of Infectious Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Sci Rep. 2024 Dec 28;14(1):31111. doi: 10.1038/s41598-024-82365-z.
Accidental bending of the snare sheath occasionally occurs during cold snare polypectomy (CSP). We aimed to demonstrate whether snare bending reduces resection ability and, if it does, what causes this reduction. Using currently available CSP snares and prototype snares, we investigated changes in the resection ability of bent snares as well as the stiffness of their sheaths and wire spindles. Furthermore, to evaluate the performance of the bent snares, we measured the completion rate of CSP for 5-mm-diameter pseudo-lesions on the porcine rectal mucosa. Snare bending significantly decreased resection ability and wire spindle stiffness. Compared with bending the snares once, bending the snares five times further decreased the resection ability and wire spindle stiffness. A strong correlation was observed between wire spindle stiffness and resection ability after snare bending (correlation coefficient = 0.82; P < 0.001). Additionally, snare bending reduced the completion rate of CSP. Bending a CSP snare causes decreased wire spindle stiffness, thereby reducing its resection ability and potentially lowering the resection completion rate. The resection ability cannot be restored; therefore, snare replacement is recommended.
冷圈套器息肉切除术（CSP）过程中偶尔会出现圈套器鞘管意外弯曲的情况。我们旨在证明圈套器弯曲是否会降低切除能力，如果会，是什么导致了这种降低。我们使用现有的CSP圈套器和原型圈套器，研究了弯曲圈套器的切除能力变化及其鞘管和钢丝轴的硬度。此外，为了评估弯曲圈套器的性能，我们测量了猪直肠黏膜上直径5毫米假病变的CSP完成率。圈套器弯曲显著降低了切除能力和钢丝轴硬度。与圈套器弯曲一次相比，弯曲五次进一步降低了切除能力和钢丝轴硬度。圈套器弯曲后，钢丝轴硬度与切除能力之间存在很强的相关性（相关系数 = 0.82；P < 0.001）。此外，圈套器弯曲降低了CSP的完成率。弯曲CSP圈套器会导致钢丝轴硬度降低，从而降低其切除能力，并可能降低切除完成率。切除能力无法恢复；因此，建议更换圈套器。
