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Comparison of endoscopic mucosal cold and hot snare resection in the treatment of 6-10 mm sessile colorectal polyps
Received:August 05, 2020  Revised:September 15, 2020  Click here to download the full text
Citation of this paper:XU Wei,HU Xue-jun,YAO Ping,SHEN Ming,ZHONG Xiao-feng,QIU Quan-xing,TANG Yu,HUA Hai-bing,LI Quan-lin.Comparison of endoscopic mucosal cold and hot snare resection in the treatment of 6-10 mm sessile colorectal polyps[J].Chinese Journal of Clinical Medicine,2020,27(6):1002-1006
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Author NameAffiliationE-mail
XU Wei Department of Gastroenterology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin 214400, Jiangsu, China  
HU Xue-jun Department of Gastroenterology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin 214400, Jiangsu, China  
YAO Ping Department of Gastroenterology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin 214400, Jiangsu, China  
SHEN Ming Department of Gastroenterology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin 214400, Jiangsu, China  
ZHONG Xiao-feng Department of Gastroenterology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin 214400, Jiangsu, China  
QIU Quan-xing Department of Gastroenterology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin 214400, Jiangsu, China  
TANG Yu Department of Gastroenterology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin 214400, Jiangsu, China  
HUA Hai-bing Department of Gastroenterology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin 214400, Jiangsu, China  
LI Quan-lin Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China liquanlin321@126.com 
Abstract:Objective: To explore endoscopic mucosal resection using cold snare (CS-EMR) versus hot snare (HS-EMR) for 6-10 mm sessile colorectal polyps.Methods: From January, 2016 to June, 2017, 110 patients who were treated in Jiangyin Hospital of traditional Chinese medicine with 131 polyps were consecutively included and randomly assigned to two groups: CS-EMR and HS-EMR groups. Submucosal injection with normal saline mixed with methylene blue was performed in both groups. To analyze the rate of complete resection, procedure time, adverse events including intraoperative bleeding or perforation, postoperative bleeding within one month, as well as the incidence of polyp residue or recurrence within six months.Results: CS-EMR group included 55 patients with 62 polyps and HS-EMR group included 55 patients with 69 polyps. There was no significant difference in the size, location, morphology, or pathology of the polyps. The rates of complete resection in CS-EMR and HS-EMR were 95.2% and 91.3%, respectively (P=0.60). The operation time of the CS-EMR group was shorter than that of the HS-EMR group ([2.2±1.1]min vs[3.6±1.4] min, P<0.01). In the CS-EMR group, there was 1 case of intraoperative bleeding and 1 case of delayed bleeding; in HS-EMR group, there were 2 cases of intraoperative bleeding, 1 case of intraoperative perforation, and 1 case of delayed bleeding. There was no difference in the adverse event rate (P=0.68). Repeat colonoscopy in 6 months showed no polyp residual or recurrence.Conclusion: CS-EMR appears to be a valuable modification of the standard cold snare technique for the treatment of 6-10 mm sessile colorectal polyps.
keywords:cold snare endoscopic mucosal resection  hot snare endoscopic mucosal resection  submucosal injection  sessile  sessile colorectal polyps
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