Fu Biao, Zhou Xiangrong, Xiaofeng Tian, Du Zhi Qiang, Wang Fei, Xu Da Hai, Yue Wang, Jin Wang, Liu Wei-Hui
Department of Gastroenterology, Jianyang People's Hospital, Jianyang, Chengdu, China.
Department of Internal Medicine I, Jianyang Hospital of Traditional Chinese Medicine, Jianyang, Chengdu, Sichuan Province, China.
Endosc Int Open. 2025 Apr 8;13:a25490922. doi: 10.1055/a-2549-0922. eCollection 2025.
In this study, we aimed to evaluate efficacy and safety of underwater cold snare polypectomy (UCSP) for treating colorectal adenoma.
This single-center, prospective, randomized controlled trial screened patients with colorectal adenomas measuring 4 to 9 mm in diameter that were identified through colonoscopies at the Department of Gastroenterology in Jianyang People's Hospital between April 2022 and October 2023. Patients were randomly assigned to undergo UCSP or cold snare polypectomy (CSP). Both groups underwent narrow-band imaging to determine international colorectal endoscopic morphology of type 2 noncancerous lesions. Following polyp removal, biopsy specimens were collected from the base and margins to assess the completeness of resection.
The study included 227 polyps from 172 patients; median sizes in the UCSP (n = 122) and CSP groups (n=105) were 5 mm and 6 mm, respectively. The R0 (96.7% vs. 86.7%; =0.005) and muscularis mucosa resection rates (68.9% vs. 43.8%; <0.0001) were significantly higher in the UCSP group than in the CSP group. However, operative time for the UCSP group (109.5 s; 86.8-134.3 vs. 110.0 s; 83.5-143.5 =0.890) was not significantly longer than that for the CSP group. Neither group exhibited delayed bleeding or perforations.
UCSP has a high R0 rate for colorectal adenomas measuring 4 to 9 mm.
在本研究中，我们旨在评估水下冷圈套息肉切除术（UCSP）治疗大肠腺瘤的疗效和安全性。
这项单中心、前瞻性、随机对照试验筛选了2022年4月至2023年10月间在建阳市人民医院胃肠科通过结肠镜检查发现的直径为4至9毫米的大肠腺瘤患者。患者被随机分配接受UCSP或冷圈套息肉切除术（CSP）。两组均进行窄带成像以确定2型非癌性病变的国际结直肠内镜形态。息肉切除后，从基底和边缘采集活检标本以评估切除的完整性。
该研究纳入了172例患者的227枚息肉；UCSP组（n = 122）和CSP组（n = 105）的息肉中位大小分别为5毫米和6毫米。UCSP组的R0切除率（96.7%对86.7%；P = 0.005）和黏膜肌层切除率（68.9%对43.8%；P < 0.0001）显著高于CSP组。然而，UCSP组的手术时间（109.5秒；86.8 - 134.3对110.0秒；83.5 - 143.5；P = 0.890）并不显著长于CSP组。两组均未出现延迟出血或穿孔。
对于直径4至9毫米的大肠腺瘤，UCSP具有较高的R0切除率。
