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
BACKGROUND Endoscopic cold snare resection(CSP)can enhance postoperative recovery and minimize bleeding risk in patients with 5-15 mm colorectal polyps.However,more detailed evaluations are required to assess their ad...BACKGROUND Endoscopic cold snare resection(CSP)can enhance postoperative recovery and minimize bleeding risk in patients with 5-15 mm colorectal polyps.However,more detailed evaluations are required to assess their advantages over conventional methods.AIM To evaluate the effects of endoscopic CSP on postoperative recovery and bleeding risk in patients with 5-15 mm colorectal polyps.METHODS This randomized controlled study included 193 patients(mean age:57.91±5.41 years;97 men and 96 women)with 5-15 mm colorectal polyps treated at Dongyang People's Hospital between March and June 2023.The patients were randomly assigned to the experimental group(n=100),who underwent CSP,and the control group(n=93),who underwent conventional endoscopic mucosal resection(EMR).Operation time,hospital stay,dietary status,and bleeding rate within 3 days were compared.RESULTS The CSP group had significantly shorter operation times(15.02±2.44 minutes vs 18.78±5.48 minutes,P<0.001)and hospital stays(3.11±1.08 days vs 4.89±1.35 days,P<0.001)than the EMR group.The fasting rate on the day of surgery was also lower in the CSP group(P<0.05).The complete resection rates were similar between groups(98.00%vs 94.62%,P=0.210),and no perforations occurred in either group.The 3-day postoperative bleeding rate was slightly lower in the CSP group(2.00%)than in the EMR group(6.45%),although this difference was not statistically significant(P=0.234),indicating limited clinical relevance.CONCLUSION CSP was safe and efficient for removing 5-15 mm colorectal polyps,offering faster recovery and comparable safety to EMR.The procedural efficiency of CSP supports its broad clinical application.展开更多
BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences b...BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences between CSP and traditional endoscopic mucosal resection(EMR)for the treatment of intestinal polyps.AIM To compare the efficacy-cost of EMR and CSP in the treatment of intestinal polyps.METHODS A total of 100 patients with intestinal polyps were included in the retrospective data of our hospital from April 2022 to May 2023.According to the treatment methods,they were divided into EMR(n=46)group and CSP(n=54)group.The baseline data of the two groups were balanced by 1:1 propensity score matching(PSM),and the cost-effectiveness analysis was performed on the two groups after matching.The recurrence rate of the two groups of patients was followed up for 1 year,and they were divided into recurrence group and non-recurrence group according to whether they recurred.Multivariate logistic regression analysis was used to screen out the influencing factors affecting the recurrence of intestinal polyps after endoscopic resection.RESULTS Significant disparities were observed in the number of polyps and smoking background between the two groups before PSM(P<0.05).Following PSM,the number of polyps and smoking history were well balanced between the EMR and CSP groups.The direct cost incurred by the CSP group was markedly higher than that incurred by the EMR group.Concurrently,the cost-effectiveness ratio in the CSP group was substantially reduced when juxtaposed with that in the EMR group(P<0.05).Upon completion of the 1-year follow-up,the rate of recurrence after endoscopic intestinal polypectomy was 38.00%.Multivariate methods revealed that age≥60 years,male sex,number of polyps≥3,and pathological type of adenoma were risk factors for recurrence after endoscopic intestinal polypectomy(all P<0.05).CONCLUSION CSP was more cost-effective for the treatment of intestinal polyps.An age≥60 years,male sex,having a number of polyps≥3,and pathological type of adenoma are independent influencing factors for recurrence.展开更多
BACKGROUND Colorectal cancer remains a considerable challenge in healthcare nowadays.Approximately 60%-80%of colorectal cancer is caused by intestinal polyps,and resection of intestinal polyps has been proved to reduc...BACKGROUND Colorectal cancer remains a considerable challenge in healthcare nowadays.Approximately 60%-80%of colorectal cancer is caused by intestinal polyps,and resection of intestinal polyps has been proved to reduce the incidence of colorectal cancer.The vast majority of intestinal polyps can be found during colonoscopy and removed endoscopically.Therefore,more attention has been paid to the development of endoscopic resection of intestinal polyps.In this study,we compared the efficacy and safety of cold snare polypectomy(CSP)and hot snare polypectomy(HSP).AIM To investigate the efficacy and safety of CSP and HSP for colorectal polyps.METHODS Between January and December 2020,301 patients with colorectal polyps 4-9 mm in diameter were treated with endoscopic therapy in our hospital,and were divided into the CSP group(n=154)and HSP group(n=147).The operating time,incidence of bleeding and perforation,use of titanium clips,and complete resection rate were compared between the two groups.RESULTS We included 249 patients(301 polyps).No differences in gender,age,and polyp size,location,shape and type were observed between the CSP and HSP groups,and the resection rates in these two groups were 93.4%and 94.5%,respectively,with no significant difference.The use of titanium clips was 15.6%and 95.9%,the operating time was 3.2±0.5 min and 5.6±0.8 min,the delayed bleeding rate was 0%and 2.0%,and delayed perforation was 0%and 0.7%,in the CSP and HSP groups,respectively.CONCLUSIONFor sessile colorectal polyps < 10 mm, CSP had the same resection rate of impaired tissue integrityas traditional HSP had. The rate of complications was lower in the CSP group. CSP is a safe andeffective method for polypectomy.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BACKGROUND Endoscopic cold snare resection(CSP)can enhance postoperative recovery and minimize bleeding risk in patients with 5-15 mm colorectal polyps.However,more detailed evaluations are required to assess their advantages over conventional methods.AIM To evaluate the effects of endoscopic CSP on postoperative recovery and bleeding risk in patients with 5-15 mm colorectal polyps.METHODS This randomized controlled study included 193 patients(mean age:57.91±5.41 years;97 men and 96 women)with 5-15 mm colorectal polyps treated at Dongyang People's Hospital between March and June 2023.The patients were randomly assigned to the experimental group(n=100),who underwent CSP,and the control group(n=93),who underwent conventional endoscopic mucosal resection(EMR).Operation time,hospital stay,dietary status,and bleeding rate within 3 days were compared.RESULTS The CSP group had significantly shorter operation times(15.02±2.44 minutes vs 18.78±5.48 minutes,P<0.001)and hospital stays(3.11±1.08 days vs 4.89±1.35 days,P<0.001)than the EMR group.The fasting rate on the day of surgery was also lower in the CSP group(P<0.05).The complete resection rates were similar between groups(98.00%vs 94.62%,P=0.210),and no perforations occurred in either group.The 3-day postoperative bleeding rate was slightly lower in the CSP group(2.00%)than in the EMR group(6.45%),although this difference was not statistically significant(P=0.234),indicating limited clinical relevance.CONCLUSION CSP was safe and efficient for removing 5-15 mm colorectal polyps,offering faster recovery and comparable safety to EMR.The procedural efficiency of CSP supports its broad clinical application.
文摘BACKGROUND Although substantial evidence supports the advantages of cold snare polypectomy(CSP)in terms of polypectomy efficacy and reduced postoperative adverse events,few studies have examined the cost differences between CSP and traditional endoscopic mucosal resection(EMR)for the treatment of intestinal polyps.AIM To compare the efficacy-cost of EMR and CSP in the treatment of intestinal polyps.METHODS A total of 100 patients with intestinal polyps were included in the retrospective data of our hospital from April 2022 to May 2023.According to the treatment methods,they were divided into EMR(n=46)group and CSP(n=54)group.The baseline data of the two groups were balanced by 1:1 propensity score matching(PSM),and the cost-effectiveness analysis was performed on the two groups after matching.The recurrence rate of the two groups of patients was followed up for 1 year,and they were divided into recurrence group and non-recurrence group according to whether they recurred.Multivariate logistic regression analysis was used to screen out the influencing factors affecting the recurrence of intestinal polyps after endoscopic resection.RESULTS Significant disparities were observed in the number of polyps and smoking background between the two groups before PSM(P<0.05).Following PSM,the number of polyps and smoking history were well balanced between the EMR and CSP groups.The direct cost incurred by the CSP group was markedly higher than that incurred by the EMR group.Concurrently,the cost-effectiveness ratio in the CSP group was substantially reduced when juxtaposed with that in the EMR group(P<0.05).Upon completion of the 1-year follow-up,the rate of recurrence after endoscopic intestinal polypectomy was 38.00%.Multivariate methods revealed that age≥60 years,male sex,number of polyps≥3,and pathological type of adenoma were risk factors for recurrence after endoscopic intestinal polypectomy(all P<0.05).CONCLUSION CSP was more cost-effective for the treatment of intestinal polyps.An age≥60 years,male sex,having a number of polyps≥3,and pathological type of adenoma are independent influencing factors for recurrence.
文摘BACKGROUND Colorectal cancer remains a considerable challenge in healthcare nowadays.Approximately 60%-80%of colorectal cancer is caused by intestinal polyps,and resection of intestinal polyps has been proved to reduce the incidence of colorectal cancer.The vast majority of intestinal polyps can be found during colonoscopy and removed endoscopically.Therefore,more attention has been paid to the development of endoscopic resection of intestinal polyps.In this study,we compared the efficacy and safety of cold snare polypectomy(CSP)and hot snare polypectomy(HSP).AIM To investigate the efficacy and safety of CSP and HSP for colorectal polyps.METHODS Between January and December 2020,301 patients with colorectal polyps 4-9 mm in diameter were treated with endoscopic therapy in our hospital,and were divided into the CSP group(n=154)and HSP group(n=147).The operating time,incidence of bleeding and perforation,use of titanium clips,and complete resection rate were compared between the two groups.RESULTS We included 249 patients(301 polyps).No differences in gender,age,and polyp size,location,shape and type were observed between the CSP and HSP groups,and the resection rates in these two groups were 93.4%and 94.5%,respectively,with no significant difference.The use of titanium clips was 15.6%and 95.9%,the operating time was 3.2±0.5 min and 5.6±0.8 min,the delayed bleeding rate was 0%and 2.0%,and delayed perforation was 0%and 0.7%,in the CSP and HSP groups,respectively.CONCLUSIONFor sessile colorectal polyps < 10 mm, CSP had the same resection rate of impaired tissue integrityas traditional HSP had. The rate of complications was lower in the CSP group. CSP is a safe andeffective method for polypectomy.
