Hot snare vs. cold snare polypectomy for endoscopic removal of 4 – 10 mm colorectal polyps during colonoscopy: a systematic review and meta-analysis of randomized controlled studies
| Autor: | Muhammad Aziz, Lorenzo Fuccio, Prateek Sharma, Tarun Rai, Madhav Desai, Tharani Sundararajan, Cesare Hassan, Alessandro Repici, Mahendran Jayaraj, Ramprasad Jegadeesan, Ahmed Saeed, Pratiksha Singh, Viveksandeep Thogulva Chandrasekar, Abhishek Choudhary, Venkata Subhash Gorrepati |
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| Přispěvatelé: | Jegadeesan, Ramprasad, Aziz, Muhammad, Desai, Madhav, Sundararajan, Tharani, Gorrepati, Venkata Subhash, Chandrasekar, Viveksandeep Thogulva, Jayaraj, Mahendran, Singh, Pratiksha, Saeed, Ahmed, Rai, Tarun, Choudhary, Abhishek, Repici, Alessandro, Hassan, Cesare, Fuccio, Lorenzo, Sharma, Prateek |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Original article medicine.medical_treatment Colonoscopy Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine Biopsy parasitic diseases Medicine Letter to the editor cancer Pharmacology (medical) resection lcsh:RC799-869 endoscopy medicine.diagnostic_test business.industry Odds ratio Confidence interval Polypectomy Endoscopy 030220 oncology & carcinogenesis Meta-analysis Resection margin polyp adenoma 030211 gastroenterology & hepatology lcsh:Diseases of the digestive system. Gastroenterology business |
| Zdroj: | Endoscopy International Open Endoscopy International Open, Vol 07, Iss 05, Pp E708-E716 (2019) |
| ISSN: | 2196-9736 2364-3722 |
| Popis: | Introduction In recent years, cold snare polypectomy (CSP) has increasingly been used over hot snare polypectomy (HSP) for the removal of colorectal polyps (4 – 10 mm in size). However, the optimal technique (CSP vs. HSP), in terms of complete polyp resection and complications, is uncertain. Our aim was to compare incomplete resection rate (IRR) of polyps and complications using CSP vs. HSP. Methods Randomized controlled studies (RCTs) comparing CSP and HSP for removal of 4 – 10 mm colorectal polyps were considered. Studies were included in the analysis if they obtained biopsy specimens from the resection margin to confirm the absence of residual tissue and reported complications. IRR and complication rate were the outcome measures. Pooled rates were reported as Odds Ratios (OR) or risk difference with 95 % Confidence Interval (CI). Results In total, three RCTs were included in the final analysis. A total of 1051 patients with 1485 polyps were randomized to either HSP group (n = 741 polyps) or CSP group (n = 744 polyps). The overall IRR did not differ between the two groups (HSP vs. CSP: 2.4 % vs. 4.7 %; OR 0.51, 95 %CI 0.13 – 1.99, P = 0.33, I 2 = 73 %). The HSP group had a lower rate of overall complications compared to the CSP group (3.7 % vs. 6.6 %; OR 0.53, 95 % CI 0.3 – 0.94, P = 0.03, I 2 = 0 %). Polyp retrieval rates were not different between the two groups (99 % vs. 98.1 %). Conclusion Our results suggest that HSP and CSP techniques can be effectively used for the complete removal of 4 – 10 mm colorectal polyps; however, HSP has a lower incidence of overall complications. |
| Databáze: | OpenAIRE |
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