| 1 | Feasibility of cold snare polypectomy in Japan: A pilot study显示文摘AIM: To investigate the feasibility of cold snare polypectomy(CSP) in Japan.METHODS: The outcomes of 234 non-pedunculated polyps smaller than 10 mm in 61 patients who underwent CSP in a Japanese referral center were retrospectively analyzed. The cold snare polypectomies were performed by nine endoscopists with no prior experience in CSP using an electrosurgical snare without electrocautery.RESULTS: CSPs were completed for 232 of the 234 polyps. Two(0.9%) polyps could not be removed without electrocautery. Immediate postpolypectomy bleeding requiring endoscopic hemostasis occurred in eight lesions(3.4%; 95%CI: 1.1%-5.8%), but all were easily managed. The incidence of immediate bleeding after CSP for small polyps(6-9 mm) was significantly higher than that of diminutive polyps(≤ 5 mm; 15% vs 1%, respectively). Three(5%) patients complained of minor bleeding after the procedure but required no intervention. The incidence of delayed bleeding requiringendoscopic intervention was 0.0%(95%CI: 0.0%-1.7%). In total, 12% of the resected lesions could not be retrieved for pathological examination. Tumor involvement in the lateral margin could not be histologically assessed in 70(40%) lesions.CONCLUSION: CSP is feasible in Japan. However, immediate bleeding, retrieval failure and uncertain assessment of the lateral tumor margin should not be underestimated. Careful endoscopic diagnosis before and evaluation of the tumor residue after CSP are recommended when implementing CSP in Japan. | Yoji Takeuchi Takeshi Yamashina Noriko Matsuura Takashi Ito Mototsugu Fujii Kengo Nagai Fumi Matsui Tomofumi Akasaka Noboru Hanaoka Koji Higashino Hiroyasu Iishi Ryu Ishihara Henrik Thorlacius Noriya Uedo | 2015 | World Journal of Gastrointestinal Endoscopy2015,7,17: | 14 |
| 2 | Is forceps more useful than visualization for measurement of colon polyp size?显示文摘AIM: To identify whether the forceps estimation is more useful than visual estimation in the measurement of colon polyp size.METHODS: We recorded colonoscopy video clips that included scenes visualizing the polyp and scenes using open biopsy forceps in association with the polyp, which were used for an exam. A total of 40 endoscopists from the Busan Ulsan Gyeongnam Intestinal Study Group Society(BIGS) participated in this study. Participants watched 40 pairs of video clips of the scenes for visual estimation and forceps estimation, and wrote down the estimated polyp size on the exam paper. When analyzing the results of the exam, we assessed interobserver differences, diagnostic accuracy, and error range in the measurement of the polyp size.R E S U LT S : The overall intra-class correlation coefficients(ICC) of inter-observer agreement for forceps estimation and visual estimation were 0.804(95%CI: 0.731-0.873, P < 0.001) and 0.743(95%CI: 0.656-0.828, P < 0.001), respectively. The ICCs of each group for forceps estimation were higher than those for visual estimation(Beginner group, 0.761 vs 0.693; Expert group, 0.887 vs 0.840, respectively). The overall diagnostic accuracy for visual estimation was 0.639 and for forceps estimation was 0.754(P < 0.001). In the beginner group and the expert group, the diagnostic accuracy for the forceps estimation was significantly higher than that of the visual estimation(Beginner group, 0.734 vs 0.613, P < 0.001; Expert group, 0.784 vs 0.680, P < 0.001, respectively). The overall error range for visual estimation and forceps estimation were 1.48 ± 1.18 and 1.20 ± 1.10, respectively(P < 0.001). The error ranges of each group for forceps estimation were significantly smaller than those for visual estimation(Beginner group, 1.38 ± 1.08 vs 1.68 ± 1.30, P < 0.001; Expert group, 1.12 ± 1.11 vs 1.42 ± 1.11, P < 0.001, respectively).CONCLUSION: Application of the open biopsy forceps method when measuring colon polyp size could help reduce inter-observer differences and error rates. | Jae Hyun Kim Seun Ja Park Jong Hoon Lee Tae Oh Kim Hyun Jin Kim Hyung Wook Kim Sang Heon Lee Dong Hoon Baek | 2016 | World Journal of Gastroenterology2016,22,11: | 0 |