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Prospective evaluation of hot snare polypectomy with low power pure-cut current

ABSTRACT: Primary outcome(s): En bloc R0 resection rate

DISEASE(S): Colorectal Adenoma

PROVIDER: 2652583 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Resection depth for small colorectal polyps comparing cold snare polypectomy, hot snare polypectomy and underwater endoscopic mucosal resection.

Project description:Background and study aims Small colorectal polyps are removed by various methods, including cold snare polypectomy (CSP), hot snare polypectomy (HSP), and underwater endoscopic mucosal resection (UEMR), but the indications for using these methods are unclear. We retrospectively assessed the efficacy of CSP, HSP, and UEMR for small polyps, focusing on the depth of the resected specimens. Patients and methods Outpatients with non-pedunculated small polyps (endoscopically diagnosed as 6 to 9 mm), resected by two endoscopists between July 2019 and September 2020, were enrolled. We histologically evaluated the specimens resected via CSP, HSP, and UEMR. The main outcome was the containment rate of the muscularis mucosa (MM) and submucosa (SM) tissues. Results Forty polyps resected via CSP (n = 14), HSP (n = 12), or UEMR (n = 14) were enrolled after excluding 13 polyps with resection depths that were difficult to determine. The rates of specimens containing MM and SM tissue differed significantly (57 % and 29 % for CSP, 92 % and 83 % for HSP, and 100 % and 100 % for UEMR, respectively ( P = 0.005 for MM and P < 0.001 for SM tissue). Multiple logistic regression analysis showed UEMR was an independent factor relating to the containment of SM tissue. The thickness of SM tissue by CSP, HSP, and UEMR were 52 μm, 623 μm, and 1119 μm, respectively ( P < 0.001). The thickness by CSP was significantly less than those by HSP and UEMR ( P < 0.001, Bonferroni correction). Conclusions UEMR could be the best method to contain SM tissue without injection. Further studies are needed to evaluate the indication of UEMR for small polyps.

| S-EPMC9106413 | biostudies-literature

Histological outcomes between hot and cold snare polypectomy for small colorectal polyps.

Project description:To compare the complete resection rate of hot and cold snare polypectomy for small colorectal polyps.We retrospectively reviewed the medical records of 233 consecutive patients with 461 colorectal polyps up to 10 mm in diameter that were treated by hot or cold snare polypectomy between April 2014 and August 2016. Lesions treated by hot snare polypectomy (n = 137) and cold snare polypectomy (n = 324) were compared. The histological complete resection rates were evaluated between the two groups. We analyzed the relationship between factors for complete resection and clinical factors using multivariate analysis.There was a significantly higher complete resection rate in hot snare polypectomy than in cold snare polypectomy (70.5% vs. 47.3%; P < 0.001). In the analysis of subgroups categorized according to polyp size, the complete resection rate for hot snare polypectomy was significantly higher than that for cold snare polypectomy among polyps ≥6 mm (69.0% vs. 43.5%; P < 0.001). Among polyps ≤5 mm, no significant difference regarding the complete resection rate was observed between the methods (81.3% vs. 53.4%; P = 0.057). There was no significant difference in the incidence of adverse events between the two groups. Multivariate analysis revealed that using hot snare polypectomy (odds ratio 3.03; P < 0.001), small lesion size (odds ratio 1.57; P = 0.049), and lesion location in the left colon (odds ratio 1.73; P = 0.007) were independent factors for complete resection.Hot snare polypectomy provides a higher complete resection rate than does cold snare polypectomy for larger (6-10 mm) subcentimeter colorectal polyps.

| S-EPMC5539679 | biostudies-other

The validity of endoscopic resection for hemicircumferential large colorectal laterally spreading tumors.

Project description:Interventions: endoscopic resection Primary outcome(s): En-bloc and R0 resection rate Study Design: Single arm Non-randomized

| 2652992 | ecrin-mdr-crc

Prospective, Consecutive, Single-Center Study Western (Greek) Single-Center Experience of Endoscopic Submucosal Dissection (ESD) for Early Gastrointestinal Neoplasia. That is really possible in a Greek General Hospital.

Project description:Interventions: Endoscopic submucosal dissection (ESD) Primary outcome(s): Endoscopic ’en bloc’ and complete pathological R0 resection. Study Design: Single arm Non-randomized

| 2624630 | ecrin-mdr-crc

Taqman Low Density Arrays (TLDA) based microRNAs expression profile of mouse extrahepatic bileducts and gallbladders during a mouse model of biliary atresia.

Project description:Newborn Balb/c mice were injected with 1.5x10^6 fluorescent-forming units (ffu) of Rhesus rotavirus type-A or 0.9% NaCl (normal saline) intraperitoneally within 24 hours of birth to induce experimental model of biliary atresia. The extrahepatic bile ducts including gallbladder were microdissected en bloc at 3, 7 and 14 days after rhesus rotavirus or saline injection. TaqMan® Array Rodent MicroRNA Card v2.0 (A and B) were used to screen microRNAs whose expression was differently regulated after rhusus rotavirus injection compare to the normal saline controls.

2013-10-15 | GSE41593 | GEO

To investigate the standard programme of endoscopic submucosal tunnelling (ESDTT) and conventional endoscopic submucosal dissection (ESD) for the treatment of early esophagus, stomach, colorectal cancer and precancerous lesions

Project description:Interventions: Group 1:endoscopic submucosal tunnel dissection;Group 2:Routine endoscopic submucosal dissection Primary outcome(s): En bloc dissection;R0 resection rate;curative resection rate;Dissection speed Study Design: Non randomized control

| 2669338 | ecrin-mdr-crc

Application of endoscopic submucosal tunnel dissection in the early esophagus, stomach and colorectal cancer

Project description:Interventions: experimental group :endoscopic submucosal tunnel dissection ;control group:Non-endoscopic submucosal tunnel dissection Primary outcome(s): En bloc resection;R0 resection rate;Curative resection rate;Dissection speed Study Design: Non randomized control

| 2669339 | ecrin-mdr-crc

Resection of esophageal, gastric, duodenal and colorectal neoplasias by ESD – Learning curve in a prevalence-based unsupervised western setting: a retrospective, multicentric trial

Project description:Interventions: Group 1: Resection in ESD technique (Endoscopic submucosal dissection) Primary outcome(s): rate of en bloc resection, rate of R0 resection, resection speed Study Design: Allocation: ; Masking: ; Control: ; Assignment: ; Study design purpose: treatment

| 2439022 | ecrin-mdr-crc

Comparative Effectiveness of Hot Versus Cold Snare Polypectomy of Small Colorectal Polyps

Project description:This study aims to investigate the comparative effectiveness between polyp removal with or without electrical current. The investigators want to include 600 polyps in the trial. It is known that polyps have the potential to develop to cancer if left in situ, but the investigators do not know the best way to remove them completely.

| 2193079 | ecrin-mdr-crc

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

Project description: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.

| S-EPMC6854937 | biostudies-literature

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