Cold snare polypectomy without submucosal injection: safety and efficacy in 615 large serrated lesions.

Background and study aim Cold resection is becoming the standard of care for the resection of nonpedunculated colon lesions up to 10 mm in diameter. Sessile serrated adenomas/polyps (SSA/Ps), including those ≥ 10 mm, present various characteristics that make them ideal candidates for cold snare polypectomy (CSP). Patients and methods A prospectively maintained database was searched retrospectively for consecutive patients with lesions ≥ 10 mm resected between March 2013 and March 2018. During that period, all SSA/P-appearing lesions were resected using CSP without submucosal injection, except for lesions with endoscopic suspicion of dysplasia or submucosal invasion. Patients with a pathological diagnosis of SSA/P were included in the analysis. Adverse events were recorded up to 21 days following colonoscopy. Results 615 SSA/Ps ≥ 10 mm were resected during 452 colonoscopy procedures in 379 patients (mean age 54.1 years; standard deviation [SD] 11.9 years). Mean polyp size was 13.7 (SD 5.2) mm; 122 lesions (19.8 %) were ≥ 20 mm and 479 lesions (77.9 %) underwent piecemeal resection. Immediate adverse events included persistent abdominal pain that resolved spontaneously within 2 hours in three patients (0.8 %; 95 % confidence interval [CI] 0.2 %-2.3 %). One patient with persistent intraprocedural bleeding was successfully treated with a hemostatic clip. No late adverse events were detected. Surveillance colonoscopy was performed in 293 patients (77.3 %) at 23.4 (SD 11.6) months following index colonoscopy; residual/recurrent lesions were diagnosed in 23 patients (7.8 %; 95 %CI 5.0 %-11.6 %). Conclusion CSP without submucosal injection appeared to be safe and effective for the resection of large SSA/Ps.

[Safety and efficacy of cold snare resection of non-polypoid colorectal lesions (0-IIa and 0-IIb)]. / Seguridad de la resección con asa fría de lesiones colorrectales no polipoideas (0-IIa y 0-IIb) de hasta 20 mm.

BACKGROUND: Cold polypectomy is a widely used technique for removing small polyps. Little evidence is available regarding its use for removing non-polypoid colorectal lesions (NPCRL). OBJECTIVE: The main aim of this study was to assess the safety of cold snare resection of NPCRL up to 20 mm. METHODS: This was a prospective cohort study carried out from January 2009 to January 2012. Consecutive patients scheduled for colonoscopy who had at least one NPCRL were recruited. Patients undergoing antiaggregation or anticoagulation treatment were excluded. NPCRL of up to 20 mm were removed by means of a cold snare, with or without piecemeal technique. To evaluate the safety of the procedure, the measured outcomes were bleeding and perforation rates. Statistical measures as percentages with their respective confidence intervals of 95% were estimated and the level of significance was set at alpha = 0.03. The calculated interval was unilateral, because the experimental rate was 0%, and was built based on the binomial distribution. Statistix (SX9.0) was used. RESULTS: A total of 171 NPCRL were removed from 124 patients. The mean size of the lesions was 9.22 +/- 4.7 mm (range: 4 to 20 mm). The mean age of patients was 55 +/- 11 years (range: 25 to 81 years) and 56% of them were women. No immediate or delayed complications were recorded. CONCLUSIONS: Cold snare resection could be used to remove LNPCR (0-IIa and 0-IIb) measuring up to 20 mm, without immediate or delayed complications.

Seguridad de la resección con asa fría de lesiones colorrectales no polipoideas (0-IIa y 0-IIb) de hasta 20 mm. / [Safety and efficacy of cold snare resection of non-polypoid colorectal lesions (0-IIa and 0-IIb)].

BACKGROUND: Cold polypectomy is a widely used technique for removing small polyps. Little evidence is available regarding its use for removing non-polypoid colorectal lesions (NPCRL). OBJECTIVE: The main aim of this study was to assess the safety of cold snare resection of NPCRL up to 20 mm. METHODS: This was a prospective cohort study carried out from January 2009 to January 2012. Consecutive patients scheduled for colonoscopy who had at least one NPCRL were recruited. Patients undergoing antiaggregation or anticoagulation treatment were excluded. NPCRL of up to 20 mm were removed by means of a cold snare, with or without piecemeal technique. To evaluate the safety of the procedure, the measured outcomes were bleeding and perforation rates. Statistical measures as percentages with their respective confidence intervals of 95

were estimated and the level of significance was set at alpha = 0.03. The calculated interval was unilateral, because the experimental rate was 0

, and was built based on the binomial distribution. Statistix (SX9.0) was used. RESULTS: A total of 171 NPCRL were removed from 124 patients. The mean size of the lesions was 9.22 +/- 4.7 mm (range: 4 to 20 mm). The mean age of patients was 55 +/- 11 years (range: 25 to 81 years) and 56

of them were women. No immediate or delayed complications were recorded. CONCLUSIONS: Cold snare resection could be used to remove LNPCR (0-IIa and 0-IIb) measuring up to 20 mm, without immediate or delayed complications.

Seguridad de la resección con asa fría de lesiones colorrectales no polipoideas (0-IIa y 0-IIb) de hasta 20 mm / [Safety and efficacy of cold snare resection of non-polypoid colorectal lesions (0-IIa and 0-IIb)].

BACKGROUND: Cold polypectomy is a widely used technique for removing small polyps. Little evidence is available regarding its use for removing non-polypoid colorectal lesions (NPCRL). OBJECTIVE: The main aim of this study was to assess the safety of cold snare resection of NPCRL up to 20 mm. METHODS: This was a prospective cohort study carried out from January 2009 to January 2012. Consecutive patients scheduled for colonoscopy who had at least one NPCRL were recruited. Patients undergoing antiaggregation or anticoagulation treatment were excluded. NPCRL of up to 20 mm were removed by means of a cold snare, with or without piecemeal technique. To evaluate the safety of the procedure, the measured outcomes were bleeding and perforation rates. Statistical measures as percentages with their respective confidence intervals of 95

were estimated and the level of significance was set at alpha = 0.03. The calculated interval was unilateral, because the experimental rate was 0

, and was built based on the binomial distribution. Statistix (SX9.0) was used. RESULTS: A total of 171 NPCRL were removed from 124 patients. The mean size of the lesions was 9.22 +/- 4.7 mm (range: 4 to 20 mm). The mean age of patients was 55 +/- 11 years (range: 25 to 81 years) and 56

of them were women. No immediate or delayed complications were recorded. CONCLUSIONS: Cold snare resection could be used to remove LNPCR (0-IIa and 0-IIb) measuring up to 20 mm, without immediate or delayed complications.