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1Feasibility 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 2015World Journal of Gastrointestinal Endoscopy2015,7,17:14
2Efficacy and adverse events of cold vs hot polypectomy: A meta-analysis显示文摘AIM: To compare previously reported randomized controlled studies(RCTs) of cold and hot polypectomy, we systematically reviewed and clarify the utility of cold polypectomy over hot with respect to efficacy and adverse events.METHODS: A meta-analysis was conducted to evaluate the predominance of cold and hot polypectomy for removing colon polyps. Published articles and abstracts from worldwide conferences were searched using the keywords 'cold polypectomy'. RCTs that compared either or both the effects or adverse events of cold polypectomy with those of hot polypectomy were collected. The patients' demographics, endoscopic procedures, No. of examined lesions, lesion size, macroscopic and histologic findings, rates of incomplete resection, bleeding amount, perforation, and length of procedure were extracted from each study. A forest plot analysis was used to verify the relative strength of the effects and adverse events of each procedure. A funnel plot was generated to assess the possibility of publication bias.RESULTS: Ultimately, six RCTs were selected. No significant differences were noted in the average lesion size(less than 10 mm) between the cold and hot polypectomy groups in each study. Further, the rates of complete resection and adverse events, including delayed bleeding, did not differ markedly between cold and hot polypectomy. The average procedural time in the cold polypectomy group was significantly shorter than in the hot polypectomy group.CONCLUSION: Cold polypectomy is a time-saving procedure for removing small polyps with markedly similar curability and safety to hot polypectomy.Mikihiro Fujiya Hiroki Sato Nobuhiro Ueno Aki Sakatani Kazuyuki Tanaka Tatsuya Dokoshi Shugo Fujibayashi Yoshiki Nomura Shin Kashima Takuma Gotoh Junpei Sasajima Kentaro Moriichi Jiro Watari Yutaka Kohgo 2016World Journal of Gastroenterology2016,22,23:3
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