BACKGROUND Cold snare polypectomy(CSP)is comparatively safe and effective for removing polyps less than 10 mm in size with lower rates of postpolypectomy syndrome and delayed postpolypectomy bleeding compared with hot...BACKGROUND Cold snare polypectomy(CSP)is comparatively safe and effective for removing polyps less than 10 mm in size with lower rates of postpolypectomy syndrome and delayed postpolypectomy bleeding compared with hot snare polypectomy(HSP).Recently,CSP is also expanded for removing polyps larger than 10 mm in size.AIM To compare the efficiency and safety of CSP and HSP in the management of 10-19 mm non-pedunculated colorectal polyps.METHODS A total of 1686 inpatients with at least one 10-19 mm non-pedunculated colorectal polyp,who underwent CSP(study group,n=843)or HSP(control group,n=843)at our Digestive Endoscopy Center between February 2020 and February 2024 were enrolled.The outcome measures including complete resection rate,intraoperative bleeding rate,and healthcare expenses such as procedure time and treatment cost were compared between the CSP vs HSP groups.RESULTS No statistically significant intergroup difference was observed in histological complete resection rates(P>0.05).Polyp resection time in the study group(76.5±23.6 seconds)was notably shorter than that in the control group(91.24±32.06 seconds;P<0.05).The immediate intraoperative bleeding rate was significantly higher in the study group than in the control group(12.7%vs 4.9%,P<0.05).No instances of delayed bleeding or perforation were documented in either group.Hospitalization duration was significantly reduced in the study group(2.42±0.61 days)compared to the control group(3.21±1.02 days;P<0.05).CONCLUSION For 10-19 mm non-pedunculated colorectal polyps,CSP demonstrates operational efficiency advantages over HSP in terms of procedure time,treatment cost,and length of hospital stay.Both techniques demonstrate robust safety profiles;however,CSP is associated with a higher intraoperative bleeding rate.Clinical decision-making should incorporate individualized assessment of these factors.展开更多
Endoscopic ectomy of large nonpedunculated colorectal lesions(≥20 mm)might cause significant adverse incidents,such as delayed perforation and delayed bleeding,despite the closure of mucosal lesions with clips.The co...Endoscopic ectomy of large nonpedunculated colorectal lesions(≥20 mm)might cause significant adverse incidents,such as delayed perforation and delayed bleeding,despite the closure of mucosal lesions with clips.The conventional utilization of prophylactic clipping has not decreased the risk of postprocedural delayed adverse events,and additional outcomes and cost-effectiveness research is needed for patients with proximal lesions≥20 mm,in whom prophylactic clipping might be useful.Coverage of the wound after endoscopic excision offers shield protection against delayed concomitant diseases.展开更多
文摘BACKGROUND Cold snare polypectomy(CSP)is comparatively safe and effective for removing polyps less than 10 mm in size with lower rates of postpolypectomy syndrome and delayed postpolypectomy bleeding compared with hot snare polypectomy(HSP).Recently,CSP is also expanded for removing polyps larger than 10 mm in size.AIM To compare the efficiency and safety of CSP and HSP in the management of 10-19 mm non-pedunculated colorectal polyps.METHODS A total of 1686 inpatients with at least one 10-19 mm non-pedunculated colorectal polyp,who underwent CSP(study group,n=843)or HSP(control group,n=843)at our Digestive Endoscopy Center between February 2020 and February 2024 were enrolled.The outcome measures including complete resection rate,intraoperative bleeding rate,and healthcare expenses such as procedure time and treatment cost were compared between the CSP vs HSP groups.RESULTS No statistically significant intergroup difference was observed in histological complete resection rates(P>0.05).Polyp resection time in the study group(76.5±23.6 seconds)was notably shorter than that in the control group(91.24±32.06 seconds;P<0.05).The immediate intraoperative bleeding rate was significantly higher in the study group than in the control group(12.7%vs 4.9%,P<0.05).No instances of delayed bleeding or perforation were documented in either group.Hospitalization duration was significantly reduced in the study group(2.42±0.61 days)compared to the control group(3.21±1.02 days;P<0.05).CONCLUSION For 10-19 mm non-pedunculated colorectal polyps,CSP demonstrates operational efficiency advantages over HSP in terms of procedure time,treatment cost,and length of hospital stay.Both techniques demonstrate robust safety profiles;however,CSP is associated with a higher intraoperative bleeding rate.Clinical decision-making should incorporate individualized assessment of these factors.
文摘Endoscopic ectomy of large nonpedunculated colorectal lesions(≥20 mm)might cause significant adverse incidents,such as delayed perforation and delayed bleeding,despite the closure of mucosal lesions with clips.The conventional utilization of prophylactic clipping has not decreased the risk of postprocedural delayed adverse events,and additional outcomes and cost-effectiveness research is needed for patients with proximal lesions≥20 mm,in whom prophylactic clipping might be useful.Coverage of the wound after endoscopic excision offers shield protection against delayed concomitant diseases.
