Efficacy and Safety of Cold Snare Polypectomy (CSP) of Intermediate Sized Colorectal Polyps 10 - 15 MM - A Prospective Observational Feasibility Trial (COLDSNAP-1)

Aims Cold snare polypectomy (CSP) has been gaining interest in recent years and is already an integral part of guidelines for polyps <10mm in size. In contrast to hot snare polypectomy (HSP), CSP doesn’t involve electrocautery and therefore shows less adverse events (AE) with comparable resection rates. However, little is known about histological resection rates of CSP for adenomas 10 - 15 mm. Therefore, this study evaluates the efficacy and safety of CSP for these adenomas.

Methods This ongoing prospective observational study investigates the feasibility and safety of CSP for adenomatous polyps and sessile serrated lesions (SSL) 10 - 15 mm. Suitable polyps are removed using a hybrid snare (SnareMaster Plus, Olympus). The primary outcome is the histological complete resection rate, determined by pathologically negative margins of the specimen and no residues adenomatous material obtained from four biopsies of the resection site. Secondary outcomes are en-bloc resection rate, failure of CSP with conversion to HSP and the incidence of adverse events.

Results A total of 40 polyps in 24 patients have been included. The mean polyp size was 12.1 mm, 75 % (30/40) of these polyps were adenomas and 25 % (10/40) were SSL. The histological complete resection rate by CSP was 83.3 % (25/30). En-bloc resection could be achieved in 60 % (18/30). Primary CSP failed with 10 (25 %) polyps most likely due to large amount of tissue within the snare. These polyps were successfully removed after conversion to HSP with the same snare. Immediate bleeding occurred with 16 (53.3 %) lesions, which were treated by hemoclips (2.13 clips on average). No other adverse events were observed.

Conclusions CSP seems to be efficient and safe in removing 10 – 15 mm colorectal polyps. A hybrid snare seems to be particular advantageous for larger polyps as it allows immediate conversion to HSP if CSP might fail.

Citation: Rechberger P, Ulrich JD, Abdelhafez M et al. eP221 EFFICACY AND SAFETY OF COLD SNARE POLYPECTOMY (CSP) OF INTERMEDIATE SIZED COLORECTAL POLYPS 10 - 15 MM - A PROSPECTIVE OBSERVATIONAL FEASIBILITY TRIAL (COLDSNAP-1). Endoscopy 2021; 53: S171.

Publikationsverlauf

Artikel online veröffentlicht:
19. März 2021