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Risk factors for incomplete polyp resection after cold snare polypectomy

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Abstract

Background

Incomplete polyp resection (IPR) is recognized as a risk factor for interval colorectal cancer (ICC), and is, therefore, an important issue in polypectomy. Cold snare polypectomy (CSP) is a procedure that does not involve electrocautery and has no burn effect. Therefore, there is the possibility that the risk of ICC associated with IPR is higher in cases undergoing CSP than in those undergoing hot polypectomy. However, little is known about the risk factors for IPR after CSP.

Purpose

Precise identification of the risk factors can lead to prevention of IPR after CSP. Therefore, we performed this observational study for accurate identification of the risk factors for IPR after CSP.

Methods

Medical records of a total of 501 patients with 1177 colorectal polyps that were resected at Omori Red Cross Hospital between October 2017 and March 2018 were retrospectively reviewed. The lateral and deep margins of the resected polyps were evaluated to check for the resection completeness.

Results

Among the 1177 polyp resections, 1163 were included in the final analysis. IPR was detected in 206 (17.7%) cases. Performance of the resection by a trainee (OR (95% CI) 1.87 (1.328–2.632); P < 0.001) was identified as an independent risk factor for IPR in patients undergoing CSP.

Conclusions

Performance of the polypectomy by a trainee was identified as a significant risk factor for IPR in patients undergoing CSP. Prospective, randomized studies are necessary in the future to develop effective methods for the prevention/control of IPR after CSP.

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Acknowledgments

The authors would like to thank the staff of the participating institutions for their support in recruiting eligible patients, and also the patients who participated in this study.

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Authors and Affiliations

Authors

Contributions

JA, HC, TH, TG, and AN conceived the study. JA, KA, JT, TN, HK, and MN performed the CSP. JA and RF recruited the study participants. Analysis and interpretation of the data was conducted by JA, NM, and HC. All the authors have read the final manuscript and approve of its submission for publication.

Corresponding author

Correspondence to Atsushi Nakajima.

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The authors declare that they have no conflict of interest.

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Arimoto, J., Chiba, H., Higurashi, T. et al. Risk factors for incomplete polyp resection after cold snare polypectomy. Int J Colorectal Dis 34, 1563–1569 (2019). https://doi.org/10.1007/s00384-019-03347-6

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