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Title: Cold snare polypectomy (CSP)/Cold EMR (C-EMR) for medium-sized (10-19mm) sessile colonic polyps: A prospective multicentre study.
Author: Mangira, D.
Raftopoulos, S.
Hartley, I.
Mack, A.
Gazelakis, K.
Nalankilli, K.
Elliott, Timothy R.
Moss, A.
Issue Date: 2022
Conference Name: ESGE Days 2022
Conference Date: April 28-30
Conference Place: Prague
Abstract: Aims: CSP is the standard of care for resecting small (<10mm) colonic polyps. However, limited data exists for its efficacy for medium-sized (10-19mm) sessile polyps. This study evaluated the efficacy and safety of CSP/C-EMR for medium-sized sessile colonic polyps. Methods: An Australian prospective multicentre study was conducted between May-2018 and June-2021, including all consecutive cases of CSP/C-EMR for 10-19mm sessile colonic polyps. Once resection was deemed complete, the margins of resection sites were biopsied circumferentially and centrally. Primary outcome: presence of residual polyp in these biopsy specimens. Secondary outcomes: recurrence rate at first surveillance colonoscopy and rates of adverse events. Results: CSP/C-EMR was performed for 350 polyps in 295 patients. Median polyp size: 15mm. Submucosal injection to lift polyps was used in 87.1% (n=305) of polyps. Histology: 68.5% adenomas, 26.2% SSA/P without dysplasia, 3.8% SSA/P with dysplasia and 1.4% hyperplastic polyps. Primary outcome: Margin and central biopsies were positive in 1.7%(n=6) and 0.3%(n=1) of polyps respectively. Secondary outcomes: Polyp recurrence was present in 1.7%(n=4) of cases at first surveillance colonoscopy that had been completed for 64.2%(n=225) of polyps at a median interval of 9.7 months. Adverse events occurred in 3.4%(n=10) of patients: 1 had intraprocedural bleeding (clipped), 3 had self-limiting post-polypectomy bleeding, 4 had post-polypectomy pain and 2 had post-polypectomy syndrome. There were no perforations. Conclusions: CSP/C-EMR for 10-19mm sessile colonic polyps is highly effective and safe. Rates of incomplete resection and recurrence at surveillance were low, with few adverse events.
Internal ID Number: 01950
Health Subject: COLONIC POLYPS
Type: Conference
Appears in Collections:Research Output

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