Shireena Desai1, Samir Gupta2,3, Nedret Copur-Dahi2,3, Mary L Krinsky4,5. 1. Kaiser Permanente, Irvine Medical Center, Irvine, CA, 92618, USA. 2. Division of Gastroenterology, Department of Medicine, University of California San Diego Health, 9300 Campus Point Drive, La Jolla, CA, 92037, USA. 3. Gastroenterology (111D), Department of Medicine, VA San Diego Healthcare System, San Diego, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA. 4. Division of Gastroenterology, Department of Medicine, University of California San Diego Health, 9300 Campus Point Drive, La Jolla, CA, 92037, USA. mkrinsky@ucsd.edu. 5. Gastroenterology (111D), Department of Medicine, VA San Diego Healthcare System, San Diego, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA. mkrinsky@ucsd.edu.
Abstract
BACKGROUND AND AIMS: The quality of colonoscopy is essential for successful colon cancer screening. Inadequate polypectomy technique can contribute to incomplete polypectomy. The primary outcome of this study was to compare the incomplete resection rate (IRR) for cold jumbo forceps polypectomy (JFP) and cold snare polypectomy (CSP). Secondary outcomes were to compare the rates of tissue retrieval and rates of procedure-related complications. METHODS: This prospective randomized parallel-group study assigned patients undergoingcolonoscopy to jumbo biopsy forceps polypectomy (JFP) or cold snare polypectomy (CSP) for polyps ≤ 6 mm in size. After polyp removal was complete, the base of the polypectomy site was biopsied to evaluate for the presence of residual polyp tissue. RESULTS: The resection quality was evaluated in 151 patients with 261 polyps ≤ 6 mm. The IRR was 9.6% (25/261) for all polyps, 11.1% (16/144) for JFP, and 7.7% (9/117) for CSP (P = 0.41). Failure of tissue retrieval was noted in 0/144 (0%) of JFP and 5/117 (4.3%) of CSP (P = 0.02). There were no procedure-related complications in either group. CONCLUSION: Colon polyps are incompletely resected in a small but potentially significant percentage of cases. IRR are similar with the use of cold jumbo forceps and cold snare. Use of cold jumbo forceps may result in more successful tissue retrieval as compared to cold snare.
RCT Entities:
BACKGROUND AND AIMS: The quality of colonoscopy is essential for successful colon cancer screening. Inadequate polypectomy technique can contribute to incomplete polypectomy. The primary outcome of this study was to compare the incomplete resection rate (IRR) for cold jumbo forceps polypectomy (JFP) and cold snare polypectomy (CSP). Secondary outcomes were to compare the rates of tissue retrieval and rates of procedure-related complications. METHODS: This prospective randomized parallel-group study assigned patients undergoing colonoscopy to jumbo biopsy forceps polypectomy (JFP) or cold snare polypectomy (CSP) for polyps ≤ 6 mm in size. After polyp removal was complete, the base of the polypectomy site was biopsied to evaluate for the presence of residual polyp tissue. RESULTS: The resection quality was evaluated in 151 patients with 261 polyps ≤ 6 mm. The IRR was 9.6% (25/261) for all polyps, 11.1% (16/144) for JFP, and 7.7% (9/117) for CSP (P = 0.41). Failure of tissue retrieval was noted in 0/144 (0%) of JFP and 5/117 (4.3%) of CSP (P = 0.02). There were no procedure-related complications in either group. CONCLUSION:Colon polyps are incompletely resected in a small but potentially significant percentage of cases. IRR are similar with the use of cold jumbo forceps and cold snare. Use of cold jumbo forceps may result in more successful tissue retrieval as compared to cold snare.
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