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Repeat Cold Snare Polypectomy Can Be Performed for Recurrent Benign Lesions After Cold Snare Polypectomy

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An Editorial to this article was published on 03 November 2021

Abstract

Background and Aims

Recurrence after cold snare polypectomy (CSP) sometimes occurs. We assessed the feasibility of repeat CSP for recurrence after CSP.

Methods

We retrospectively reviewed recurrent lesions after CSP which were resected by repeat CSP from 2016 to 2021 in our institution and analyzed clinical outcomes of repeat CSP, comparing those of non-recurrent 454 lesions receiving standard CSP in 2016 and follow-up colonoscopy. We also analyzed the recurrent rate among cases receiving follow-up in both groups. Indication of repeat CSP was lesions diagnosed as benign tumors of ≤ 10 mm.

Results

We analyzed 80 lesions receiving repeat CSP. The polyp size (mean ± standard deviation: SD) was 4.1 ± 2.3 mm (range 2–10 mm). The right-sided colon and non-polypoid morphology rates were 66.3% and 43.8%, respectively. Histopathological diagnosis was 66 adenomas, 12 sessile serrated lesions (SSLs), 1 SSL with dysplasia, and 1 high-grade dysplasia. The procedure time (min, mean ± SD) of repeat CSP was 0.9 ± 0.8. Regarding the comparison of repeat CSP/ standard CSP group, the en bloc resection and histopathological complete resection rates were 78.8%/ 98.0% (p < 0.001) and 43.8%/59.6% (p = 0.007) and the rates of perioperative hemorrhage requiring endoscopic clipping were 1.3%/ 1.0% (p = 0.646). There were no postoperative hemorrhage and perforation in both groups (p = 1.0). Among lesions receiving follow-up colonoscopy, the mean recurrence rates (number, median follow-up period: interquartile) of repeat CSP and standard CSP group were 2.0% (1/50, 12 months: 12–24) versus 0.7% (3/454, 12 months: 12–24) (p = 0.862).

Conclusions

Repeat CSP for benign recurrent lesions after CSP was safe and feasible.

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Acknowledgments

We thank Dr. Tomohiko Usui, all of the members of the Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine for their help with this study.

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Authors and Affiliations

  1. Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Naohisa Yoshida, Hikaru Hashimoto, Ken Inoue, Reo Kobayashi, Yuri Tomita, Satoshi Sugino, Ryohei Hirose, Osamu Dohi & Yoshito Itoh

  2. Department of Surgical Pathology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Yukiko Morinaga

  3. Department of Gastroenterology, Kyoto First Red Cross Hospital, Kyoto, Japan

    Yutaka Inada

  4. Department of Gastroenterology, Aiseikai Yamashina Hospital, Kyoto, Japan

    Takaaki Murakami

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  1. Naohisa Yoshida
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  2. Hikaru Hashimoto
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  3. Ken Inoue
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Correspondence to Naohisa Yoshida.

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An editorial commenting on this article is available at https://doi.org/10.1007/s10620-021-07293-8.

Supplementary Information

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Supplementary file1: Video 1. Repeat CSP with en bloc resection for a recurrent lesion (A case in Figure 1).LCI, BLI, and WLI could detect a recurrent lesion of 4 mm on a CSP scar in the sigmoid colon. Repeat CSP was performed with a dedicated snare (Exacto). An ulcer afterrepeat CSP was checked with LCI and BLI and there was no residual lesion.

Supplementary file2: Video 2. Repeat CSP with piecemeal resection for arecurrent lesion (A case in Figure 3).LCI, BLI, and WLI could detect a recurrent lesion of 8 mm on a CSP scar in the sigmoid colon. Repeat CSP was performed in a piecemeal fashion with a dedicated snare (Captivator Cold). An ulcer afterrepeat CSP was checked with LCI and BLI and there was no residual lesion.

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Yoshida, N., Hashimoto, H., Inoue, K. et al. Repeat Cold Snare Polypectomy Can Be Performed for Recurrent Benign Lesions After Cold Snare Polypectomy. Dig Dis Sci 67, 3192–3199 (2022). https://doi.org/10.1007/s10620-021-07292-9

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