Should hot biopsy forceps be abandoned for polypectomy of diminutive colorectal polyps?
| Autor: | Antonios Vezakis, J K Triantafillidis, Vasileios Panteris |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Endoscopic Mucosal Resection medicine.medical_treatment Biopsy Forceps Colonoscopy Colonic Polyps Endoscopic mucosal resection Endoscopy Gastrointestinal 03 medical and health sciences 0302 clinical medicine Medicine Humans Hot biopsy medicine.diagnostic_test business.industry General surgery Gastroenterology General Medicine Surgical Instruments Polypectomy Endoscopy Diminutive 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Neoplasm Recurrence Local business Colorectal Neoplasms |
| Zdroj: | World journal of gastroenterology. 24(14) |
| ISSN: | 2219-2840 |
| Popis: | Standardized approach to polypectomy of diminutive colorectal polyps (DCPs) is lacking since cold biopsy forceps have been associated with high levels of recurrence, hot biopsy forceps are considered inadequate and risky and cold snaring is currently under investigation for its efficacy and safety. This has led to confusion and a gap in clinical practice. This article discusses the usefulness and contemporary practical applicability of hot biopsy forceps and provides well-intentioned criticism of the new European guidelines for the treatment of DCPs. Diminutive colorectal polyps are a source of frustration for the endoscopist since their small size is accompanied by a considerable risk of premalignant neoplasia and a small but non-negligible risk of advanced neoplasia and even cancer. Since the proportion of diminutive colorectal polyps is substantial and exceeds that of larger polyps, their effective removal poses a considerable workload and a therapeutic challenge. During the last decade, the introduction of cold snaring to routine endoscopy practice has attempted to overcome the use of prior techniques, such as hot biopsy forceps. It is important to recognize that with the exception of endoscopic methods that are obviously unsafe and inadequate to serve their purpose, all other interventional endoscopic methods are operator-dependent in the sense that specific expertise and training are obligatory for the success of any therapeutic intervention. Since relevant publications on hot biopsy forceps are still in favor of its careful use, as it has not yet demonstrated inferiority compared with newer techniques, it would be prudent for any medical practitioner to evaluate the available tools and judge any new proposed technique based on the evidence before it is adopted. |
| Databáze: | OpenAIRE |
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