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A prospective randomized study comparing jumbo biopsy forceps to cold snare for the resection of diminutive colorectal polyps

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Abstract

Background and aims

The quality of colonoscopy is essential for successful colon cancer screening. Inadequate polypectomy technique can contribute to incomplete polypectomy. The primary outcome of this study was to compare the incomplete resection rate (IRR) for cold jumbo forceps polypectomy (JFP) and cold snare polypectomy (CSP). Secondary outcomes were to compare the rates of tissue retrieval and rates of procedure-related complications.

Methods

This prospective randomized parallel-group study assigned patients undergoing colonoscopy to jumbo biopsy forceps polypectomy (JFP) or cold snare polypectomy (CSP) for polyps ≤ 6 mm in size. After polyp removal was complete, the base of the polypectomy site was biopsied to evaluate for the presence of residual polyp tissue.

Results

The resection quality was evaluated in 151 patients with 261 polyps ≤ 6 mm. The IRR was 9.6% (25/261) for all polyps, 11.1% (16/144) for JFP, and 7.7% (9/117) for CSP (P = 0.41). Failure of tissue retrieval was noted in 0/144 (0%) of JFP and 5/117 (4.3%) of CSP (P = 0.02). There were no procedure-related complications in either group.

Conclusion

Colon polyps are incompletely resected in a small but potentially significant percentage of cases. IRR are similar with the use of cold jumbo forceps and cold snare. Use of cold jumbo forceps may result in more successful tissue retrieval as compared to cold snare.

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Abbreviations

UCSD:

University of California San Diego

VA:

Veterans Affairs

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Acknowledgements

The authors wish to thank Shahrokh Golshan for assistance with the statistical analysis, and Amelia Parnell for the preparation of this manuscript for submission.

Funding

An unrestricted educational grant funding from SpectraScience was used for this study. There were no institutional or corporate affiliations associated with this study.

Author information

Authors and Affiliations

  1. Kaiser Permanente, Irvine Medical Center, Irvine, CA, 92618, USA

    Shireena Desai

  2. Division of Gastroenterology, Department of Medicine, University of California San Diego Health, 9300 Campus Point Drive, La Jolla, CA, 92037, USA

    Samir Gupta, Nedret Copur-Dahi & Mary L. Krinsky

  3. Gastroenterology (111D), Department of Medicine, VA San Diego Healthcare System, San Diego, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA

    Samir Gupta, Nedret Copur-Dahi & Mary L. Krinsky

Authors
  1. Shireena Desai
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  2. Samir Gupta
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  3. Nedret Copur-Dahi
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  4. Mary L. Krinsky
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Contributions

All authors were either primary authors of the manuscript, conducted manuscript revision, or approved the final manuscript.

Corresponding author

Correspondence to Mary L. Krinsky.

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Disclosures

Shireena Desai, Samir Gupta, Nedret Copur-Dahi, and Mary L. Krinsky have no conflicts of interest or financial ties to disclose.

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Desai, S., Gupta, S., Copur-Dahi, N. et al. A prospective randomized study comparing jumbo biopsy forceps to cold snare for the resection of diminutive colorectal polyps. Surg Endosc 34, 1206–1213 (2020). https://doi.org/10.1007/s00464-019-06874-z

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  • DOI: https://doi.org/10.1007/s00464-019-06874-z

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