Cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps: a meta-analysis of randomized controlled trials

Background/Aims Cold snare polypectomy (CSP) is routinely performed for small colorectal polyps (≤10 mm). However, challenges include insufficient resection depth and immediate bleeding, hindering precise pathological evaluation. We aimed to compare the outcomes of cold endoscopic mucosal resection...

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Main Authors: Vishali Moond, Priyadarshini Loganathan, Sheza Malik, Dushyant Singh Dahiya, Babu P. Mohan, Daryl Ramai, Michele McGinnis, Deepak Madhu, Mohammad Bilal, Aasma Shaukat, Saurabh Chandan
Format: Article
Language:English
Published: Korean Society of Gastrointestinal Endoscopy 2024-11-01
Series:Clinical Endoscopy
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Online Access:http://www.e-ce.org/upload/pdf/ce-2024-081.pdf
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author Vishali Moond
Priyadarshini Loganathan
Sheza Malik
Dushyant Singh Dahiya
Babu P. Mohan
Daryl Ramai
Michele McGinnis
Deepak Madhu
Mohammad Bilal
Aasma Shaukat
Saurabh Chandan
author_facet Vishali Moond
Priyadarshini Loganathan
Sheza Malik
Dushyant Singh Dahiya
Babu P. Mohan
Daryl Ramai
Michele McGinnis
Deepak Madhu
Mohammad Bilal
Aasma Shaukat
Saurabh Chandan
author_sort Vishali Moond
collection DOAJ
description Background/Aims Cold snare polypectomy (CSP) is routinely performed for small colorectal polyps (≤10 mm). However, challenges include insufficient resection depth and immediate bleeding, hindering precise pathological evaluation. We aimed to compare the outcomes of cold endoscopic mucosal resection (CEMR) with that of CSP for colorectal polyps ≤10 mm, using data from randomized controlled trials (RCTs). Methods Multiple databases were searched in December 2023 for RCTs reporting outcomes of CSP versus CEMR for colorectal polyps ≤10 mm in size. Our primary outcomes were rates of complete and en-bloc resections, while our secondary outcomes were total resection time (seconds) and adverse events, including immediate bleeding, delayed bleeding, and perforation. Results The complete resection rates did not significantly differ (CSP, 91.8% vs. CEMR 94.6%), nor did the rates of en-bloc resection (CSP, 98.9% vs. CEMR, 98.3%) or incomplete resection (CSP, 6.7% vs. CEMR, 4.8%). Adverse event rates were similarly insignificant in variance. However, CEMR had a notably longer mean resection time (133.51 vs. 91.30 seconds). Conclusions Our meta-analysis of seven RCTs showed that while both CSP and CEMR are equally safe and effective for resecting small (≤10 mm) colorectal polyps, the latter is associated with a longer resection time.
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spelling doaj-art-f71d47f93ab74c349619bb078f7be1c72024-12-03T07:42:10ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432024-11-0157674775810.5946/ce.2024.0817906Cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps: a meta-analysis of randomized controlled trialsVishali Moond0Priyadarshini Loganathan1Sheza Malik2Dushyant Singh Dahiya3Babu P. Mohan4Daryl Ramai5Michele McGinnis6Deepak Madhu7Mohammad Bilal8Aasma Shaukat9Saurabh Chandan10 Department of Internal Medicine, Saint Peter's University Hospital/Robert Wood Johnson Medical School, New Brunswick, NJ, USA Department of Medicine, University of Texas Health Science Center, San Antonio, TX, USA Department of Medicine, Rochester General Hospital, Rochester, New York, NY, USA Division of Gastroenterology, Hepatology & Motility, The University of Kansas School of Medicine, Kansas City, KS, USA Department of Gastroenterology, Orlando Gastroenterology PA, Orlando, FL, USA Department of Gastroenterology, University of Utah, Salt Lake City, UT, USA Mayo Clinic Libraries, Rochester, MN, USA Department of Gastroenterology, Lisie Institute of Gastroenterology, Lisie Hospital, Kochi, India Division of Gastroenterology, University of Minnesota & Minneapolis VA Health Care System, Minneapolis, MN, USA Division of Gastroenterology and Hepatology, NYU Grossman School of Medicine, New York, NY, USA Center for Interventional Endoscopy, Advent Health, Orlando, FL, USABackground/Aims Cold snare polypectomy (CSP) is routinely performed for small colorectal polyps (≤10 mm). However, challenges include insufficient resection depth and immediate bleeding, hindering precise pathological evaluation. We aimed to compare the outcomes of cold endoscopic mucosal resection (CEMR) with that of CSP for colorectal polyps ≤10 mm, using data from randomized controlled trials (RCTs). Methods Multiple databases were searched in December 2023 for RCTs reporting outcomes of CSP versus CEMR for colorectal polyps ≤10 mm in size. Our primary outcomes were rates of complete and en-bloc resections, while our secondary outcomes were total resection time (seconds) and adverse events, including immediate bleeding, delayed bleeding, and perforation. Results The complete resection rates did not significantly differ (CSP, 91.8% vs. CEMR 94.6%), nor did the rates of en-bloc resection (CSP, 98.9% vs. CEMR, 98.3%) or incomplete resection (CSP, 6.7% vs. CEMR, 4.8%). Adverse event rates were similarly insignificant in variance. However, CEMR had a notably longer mean resection time (133.51 vs. 91.30 seconds). Conclusions Our meta-analysis of seven RCTs showed that while both CSP and CEMR are equally safe and effective for resecting small (≤10 mm) colorectal polyps, the latter is associated with a longer resection time.http://www.e-ce.org/upload/pdf/ce-2024-081.pdfcarcinomacoloniccolonoscopycolorectalpolyps
spellingShingle Vishali Moond
Priyadarshini Loganathan
Sheza Malik
Dushyant Singh Dahiya
Babu P. Mohan
Daryl Ramai
Michele McGinnis
Deepak Madhu
Mohammad Bilal
Aasma Shaukat
Saurabh Chandan
Cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps: a meta-analysis of randomized controlled trials
Clinical Endoscopy
carcinoma
colonic
colonoscopy
colorectal
polyps
title Cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps: a meta-analysis of randomized controlled trials
title_full Cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps: a meta-analysis of randomized controlled trials
title_fullStr Cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps: a meta-analysis of randomized controlled trials
title_full_unstemmed Cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps: a meta-analysis of randomized controlled trials
title_short Cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps: a meta-analysis of randomized controlled trials
title_sort cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps a meta analysis of randomized controlled trials
topic carcinoma
colonic
colonoscopy
colorectal
polyps
url http://www.e-ce.org/upload/pdf/ce-2024-081.pdf
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