Li Chunmei, Xie Xinyu, Qin Jian, Ding Yufei, Ma Xiaojuan, Liu Shanshan, Chen Miao, Dong Dandan, Sun Jing, Deng Xuedan, Liu Lulu, Cui Hongyan
Department of Oncology, The Fourth Division Hospital of Xinjiang Production and Construction Corps, Yining, China.
Department of Gastroenterology, The Fourth Division Hospital of Xinjiang Production and Construction Corps, Yining, China.
BMC Gastroenterol. 2025 Sep 2;25(1):631. doi: 10.1186/s12876-025-04245-8.
Screening colonoscopy plays a critical role in reducing colorectal cancer incidence by identifying and removing polyps. Simple and safe treatment is the most common request of both doctors and patients. Cold snare polypectomy (CSP) is increasingly favored for polyps < 10 mm, yet concerns remain regarding residual tissue. The aim of this study was to evaluate the efficacy and safety of CSP in the outpatient treatment of sessile polyps < 10 mm using endoscopic optical assessment.
Patients undergoing outpatient screening colonoscopy who consented to combined polypectomy were recruited, excluding those on anticoagulants or antiplatelets. CSP was performed for detected sessile polyps < 10 mm, and patients did not undergo any additional screening laboratory tests. Postoperative wounds were assessed endoscopically, and resected specimens were stained with crystalline violet for optimum pathological preparation and evaluation. Complete resection was determined separately. Complications and 7-day postoperative outcomes were recorded.
A total of 194 sessile colorectal polyps < 10 mm were resected from 77 patients, with a complete resection rate of 91.24% (95% confidence interval: 87.2-95.2%). There was a statistically significant difference in the rate of complete resection by endoscopic optical assessment compared to pathologic assessment (86.60% [168/194] vs. 72.68% [141/194], p < 0.01). Optical assessment was not significantly different from the final total resection rate (86.60% [168/194] vs. 91.24% [177/194], p = 0.15). No adverse events occurred in all patients.
CSP is a safe and effective technique for outpatient resection of sessile polyps < 10 mm. Optical assessment of postoperative defects provides a viable method for determining complete resection.
Trial registered at the Chinese Clinical Trial Registry (registration number: ChiCTR2400082461, registration date: 29/3/2024).
筛查性结肠镜检查通过识别和切除息肉在降低结直肠癌发病率方面发挥着关键作用。简单安全的治疗是医生和患者最普遍的要求。冷圈套息肉切除术（CSP）越来越受青睐用于切除直径小于10mm的息肉，但对于残留组织仍存在担忧。本研究的目的是使用内镜光学评估来评估CSP在门诊治疗直径小于10mm的无蒂息肉的疗效和安全性。
招募接受门诊筛查性结肠镜检查且同意联合息肉切除术的患者，排除正在接受抗凝或抗血小板治疗的患者。对检测到的直径小于10mm的无蒂息肉进行CSP，患者未接受任何额外的筛查实验室检查。术后伤口进行内镜评估，切除标本用结晶紫染色以进行最佳病理制备和评估。分别确定完全切除情况。记录并发症和术后7天的结果。
共从77例患者中切除194枚直径小于10mm的无蒂结直肠息肉，完全切除率为91.24%（95%置信区间：87.2 - 95.2%）。与病理评估相比，内镜光学评估的完全切除率有统计学显著差异（86.60%[168/194]对72.68%[141/194]，p < 0.01）。光学评估与最终总切除率无显著差异（86.60%[168/194]对91.24%[177/194]，p = 0.15）。所有患者均未发生不良事件。
CSP是门诊切除直径小于10mm的无蒂息肉的一种安全有效的技术。术后缺损的光学评估为确定完全切除提供了一种可行的方法。
该试验在中国临床试验注册中心注册（注册号：ChiCTR2400082461，注册日期：2024年3月29日）。
