Dataset Information

Comparison of Outcomes of Colorectal Polypectomy Using Traditional Snare and Rotary Snare: A Prospective Randomized Controlled Trial.

ABSTRACT: Background and Objective:The aim of the current study was to compare the efficacy and safety of polypectomy by using rotary snare vs. traditional snare during colonoscopy. Methods:A single-center randomized controlled trial, which included consecutive participants who were ?18 years old and detected with polyp(s) during routine colonoscopy between July and September 2018, was conducted. Participants with colorectal polyps were randomized to receive polypectomy using rotary snares or traditional snares. The primary outcome measure was the comparison of the average time of removing a polyp between those two groups. The secondary outcome measure was to compare the polyp resection time by using SMSA (size, morphology, site, and access) scores. Results:A total of two hundred participants were included in this study. Of them, 100 participants were randomly assigned to the rotary snare group (214 polyps) and the other 100 participants were randomly assigned to the traditional group (232 polyps). The mean resection time was significantly shorter in the rotary snare group than in the traditional snare group (24.41 ± 18.14 seconds vs. 29.53 ± 25.74 seconds, P = 0.021). In the subgroup analysis, the resection time was also shorter in the rotary snare group than in the traditional snare group in SMSA level 1 (18.51 ± 8.26 seconds vs.23.84 ± 15.07 seconds, P = 0.013) and in SMSA level 2 (25.03 ± 15.32 seconds vs.29.15 ± 24.82 seconds, P = 0.009), respectively. Conclusion:Colorectal polyps could be removed more efficient by using rotary snares than by using traditional snares in SMSA level 1 and SMSA level 2.

SUBMITTER: Xu L

PROVIDER: S-EPMC6854937 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Comparison of Outcomes of Colorectal Polypectomy Using Traditional Snare and Rotary Snare: A Prospective Randomized Controlled Trial.

Xu Lu L Zhang Zhixing Z Xie Jiarong J Xu Lei L Wang Weihong W

Gastroenterology research and practice 20191017

<h4>Background and objective</h4>The aim of the current study was to compare the efficacy and safety of polypectomy by using rotary snare <i>vs.</i> traditional snare during colonoscopy.<h4>Methods</h4>A single-center randomized controlled trial, which included consecutive participants who were ≥18 years old and detected with polyp(s) during routine colonoscopy between July and September 2018, was conducted. Participants with colorectal polyps were randomized to receive polypectomy using rotary ...[more]

PMID: 31772572

Similar Datasets

Project description:BackgroundColorectal cancer remains a considerable challenge in healthcare nowadays. Most patients' disease develops via the adenoma-carcinoma sequence; colonoscopy with polypectomy effectively reduces both mortality and incidence by removing precancerous adenomas. Previous studies showed that polypectomy without electrocautery (cold snaring polypectomy) is a safe and time-saving procedure to manage polyps < 10 mm. However, randomized controlled trials have failed to prove the superiority of cold snaring polypectomy for reducing the risk of delayed bleeding in comparison with hot snaring polypectomy, generally because of their low statistical power that was limited by sample sizes. In this study, we aim to compare the risk of delayed bleeding following cold and hot snaring polypectomy based on a large sample size.MethodsThis is a prospective multicentre randomized controlled trial to compare cold and hot snaring polypectomy for the treatment of small colorectal polyps. A total of 4258 patients with small polyps (4-10 mm) will be randomized 1:1 to each group. Colonoscopy and polypectomy will be performed by 17 experienced endoscopists at six study sites. The randomization will be performed via an online website. Pathological examination using image-enhanced endoscopy with either narrow-band imaging or chromoendoscopy will be conducted to confirm optically and histologically that complete resections have been achieved, respectively. The primary outcome measurement is the risk of delayed bleeding. The secondary outcome measurements include the number of hemoclip applications, complete eradication confirmed optically and histologically, tissue retrieval rate, procedure time, emergency unit visits, and any adverse events such as immediate bleeding or perforation.DiscussionWe hypothesize that cold snaring polypectomy can reduce the risk of delayed bleeding by avoiding thermal injury. In addition, this study will also compare cold and hot snaring polypectomy in terms of the complete eradication rate and procedure time. Based on data collected, we will demonstrate that cold snaring polypectomy is a safe, effective, and economic procedure for small colorectal polyps. The results will also provide additional data on which to develop recommendations for treating small colorectal polyps.Trial registrationClinicalTrials.gov, NCT03373136 . Registered on 29 November 2017.

Project description:BackgroundRemimazolam is a newer benzodiazepine with properties of rapid onset, short duration of action, and fast recovery. Our study was to evaluate the effects of different doses of remimazolam combined with alfentanil in colonoscopic polypectomy.MethodsOne hundred twenty patients were randomly divided into four groups: alfentanil and propofol (AP) group, alfentanil and remimazolam 0.1 mg/kg (AR1 group), 0.15 mg/kg (AR2 group), or 0.2 mg/kg (AR3 group). Patients in the four groups received alfentanil 10 μg/kg, followed by propofol 2 mg/kg and three dosages of remimazolam. Modified Observer's Assessment of Alertness and Sedation (MOAA/S) scale, heart rate (HR), oxygen saturation (SpO2), respiratory rate (RR), bispectral index (BIS) values and mean arterial pressure (MAP) were collected at intervals of 5 min and analyzed at different time points: before anesthesia (T0), 5 min (T1), 10 min (T2), 15 min after anesthesia (T3) and at the end of surgery (T4). The average MAP was calculated utilizing the average of all MAP values. The primary outcome was the success rate of sedation. Secondary outcomes included time to full alert and adverse events.ResultsThe success rate of sedation was 100% among the four groups. The incidence of hypotension was significantly decreased (all P < 0.05) and the average MAP was higher in AR1-AR3 groups than AP group (all P < 0.001). None of the patients developed bradycardia or hypertension during surgery in all study groups. BIS values were higher (all P < 0.001) and the time to full alert was statistically shorter in AR1-AR3 groups (all P < 0.05) compared with the AP group. The MOAA/S score in AR1 was higher than AR2 (P < 0.05) and the AR3 group (P < 0.05) at T1 and BIS values in the AR1 group were significantly higher than AR3 group (P < 0.05) at T4.ConclusionsRemimazolam combined with alfentanil have a non-inferior sedative effect than propofol during the colonoscopic polypectomy. Moreover, this combination of two short-acting drugs might be a safer alternative.Trial registrationThe clinical trial was registered on (16/05/2021, ChiCTR2100046492).

Dataset Information

Comparison of Outcomes of Colorectal Polypectomy Using Traditional Snare and Rotary Snare: A Prospective Randomized Controlled Trial.

Publications

Comparison of Outcomes of Colorectal Polypectomy Using Traditional Snare and Rotary Snare: A Prospective Randomized Controlled Trial.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets