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Hot snare polypectomy versus endoscopic mucosal resection for small colorectal polyps: a randomized controlled trial

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Abstract

Background and aims

This study was performed to compare endoscopic mucosal resection (EMR) with hot snare polypectomy (HSP) in terms of the complete resection rate and the incidence of adverse events for resecting small (5–10 mm) colorectal polyps.

Methods

Small colorectal polyps (5–10 mm) with neoplastic features were randomly allocated to either the HSP or EMR group. A submucosal injection was performed prior to hot snaring in the EMR group only. Complete resection was defined as the absence of neoplastic tissue from two additional biopsies of the polypectomy site. R0 resection was defined as the absence of neoplastic tissue at the margin of the resected specimen.

Results

A total of 362 colon polyps from 272 patients were included, and 167 polyps in the HSP group and 155 polyps in the EMR group were analyzed. Between the polypectomy techniques, there was no significant difference in the complete resection rates, which were 96.4% (161/167) in the HSP group and 95.5% (148/155) in the EMR group (P = 0.67). The R0 resection rate in the HSP and EMR groups was significantly different, with 49.7% (83/167) and 74.8% (116/155), respectively (P < 0.001). There was no significant difference in the incidence of adverse events between the two groups.

Conclusions

The complete resection rates for small (5–10 mm) polyps were not different between HSP and EMR.

Trial Registry: ClincialTrials.gov number NCT 02239536.

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Abbreviations

HSP:

Hot snare polypectomy

EMR:

Endoscopic mucosal resection

CSP:

Cold snare polypectomy

NBI:

Narrow-band imaging

NICE:

NBI International Colorectal Endoscopic classification

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Funding

This research was supported by the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Ministry of Science & ICT (NRF-2018M3A9E8021507). All other authors disclosed no financial relationships relevant to this article.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea

    Seung-Jun Kim, Bo-In Lee, Woohyeon Kim, Hyoju Ham, Minah Kim, Han Hee Lee, Jae Myung Park & Myung-Gyu Choi

  2. Department of Hospital Pathology, College of Medicine, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Republic of Korea

    Eun Sun Jung

  3. Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea

    Joon Sung Kim

  4. Department of Hospital Pathology, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea

    Sun-Young Jun

  5. Department of Hospital Pathology, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea

    Sung Hak Lee

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  1. Seung-Jun Kim
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  8. Minah Kim
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  10. Han Hee Lee
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  12. Myung-Gyu Choi
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Corresponding authors

Correspondence to Bo-In Lee or Eun Sun Jung.

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Disclosures

Dr. Bo-In Lee has consulted for Taejoon Pharm, Pentax. Co., Olympus Co., Abbvie Co., and Medtronics Co. Drs. Seung-Jun Kim, Eun Sun Jung, Joon Sung Kim, Sun-Young Jun, Woohyeon Kim, Hyoju Ham, Minah Kim, Sung Hak Lee, Han Hee Lee, Jae Myung Park, and Myung-Gyu Choi have no conflicts of interest or financial ties to disclose.

Ethical approval

The study protocol was approved by the Institutional Review Board of the Catholic Medical Center.

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Kim, SJ., Lee, BI., Jung, E.S. et al. Hot snare polypectomy versus endoscopic mucosal resection for small colorectal polyps: a randomized controlled trial. Surg Endosc 35, 5096–5103 (2021). https://doi.org/10.1007/s00464-020-07994-7

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  • DOI: https://doi.org/10.1007/s00464-020-07994-7

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