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Management of Less Than 10-mm-Sized Pedunculated (Ip) Polyps with Thin Stalk: Hot Snare Polypectomy Versus Cold Snare Polypectomy

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Abstract

Background

Although the use of cold snare polypectomy (CSP) has spread rapidly, its safety for pedunculated (Ip) polyps remains controversial. In particular, the outcomes of hot snare polypectomy (HSP) and CSP for Ip polyps have not been previously compared.

Aims

This study evaluated whether the rate of delayed postpolypectomy bleeding (DPPB) after CSP for Ip polyps was higher than that after HSP for Ip polyps and compared other outcomes (the rates of immediate bleeding and pathological margins) between the HSP and CSP procedures.

Methods

A total of 5905 colorectal polyps in 4920 patients were resected at Omori Red Cross Hospital between October 2012 and June 2019. The polyps were divided into two groups: the HSP group (86 polyps, 64 patients) and the CSP group (102 polyps, 87 patients). The primary outcome measure was the incidence of DPPB. The secondary outcome measures were the incidences of immediate bleeding during the procedure and pathological margins of the resected specimen.

Results

The rate of immediate bleeding during CSP was significantly higher than that for the HSP group [38.2% (39/102) versus 3.5% (3/86); p < 0.001]. However, the rate of DPPB was significantly higher in the HSP group than in the CSP group [4.7% (4/86) versus 0% (0/102); p < 0.001]. The rate of DPPB after CSP was 0%.

Conclusions

This is the first study to compare the outcomes of HSP and CSP for Ip polyps. CSP is safer than HSP for Ip polyps measuring < 10 mm in diameter.

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Abbreviations

CRC:

Colorectal cancer

HSP:

Hot snare polypectomy

DPPB:

Delayed postpolypectomy bleeding

CSP:

Cold snare polypectomy

EMR:

Endoscopic mucosal resection

ESGE:

European Society of Gastrointestinal Endoscopy

CFP:

Cold forceps polypectomy

PEG:

Polyethylene glycol

IPR:

Incomplete polyp resection

SD:

Standard deviation

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Acknowledgments

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

Funding

This study received no external funding. There was no sponsor for this study.

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Authors and Affiliations

  1. Department of Gastroenterology, Omori Red Cross Hospital, 4-30-1, Chuo, Ota-Ku, Tokyo, 143-8527, Japan

    Jun Arimoto, Hideyuki Chiba, Ryo Fukui, Jun Tachikawa, Naoya Okada, Takuma Suto, Naoya Kawano, Toshihiro Niikura, Hiroki Kuwabara, Michiko Nakaoka, Tomonori Ida & Tohru Goto

  2. Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan

    Keiichi Ashikari & Atsushi Nakajima

Authors
  1. Jun Arimoto
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  2. Hideyuki Chiba
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Contributions

J.A., H.C., T.G., and A.N. conceived the study. J.A., K.A., R.F., J.T., N.O., T.S., N.K., T.N., H.K., M.N., and T.I. performed the CSP. J.A. and H.C. recruited the study participants. The data analysis and interpretation were conducted by J.A. and H.C. All the authors read the final manuscript and have approved its submission for publication.

Corresponding author

Correspondence to Jun Arimoto.

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Arimoto, J., Chiba, H., Ashikari, K. et al. Management of Less Than 10-mm-Sized Pedunculated (Ip) Polyps with Thin Stalk: Hot Snare Polypectomy Versus Cold Snare Polypectomy. Dig Dis Sci 66, 2353–2361 (2021). https://doi.org/10.1007/s10620-020-06436-7

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  • DOI: https://doi.org/10.1007/s10620-020-06436-7

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