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International Journal of Colorectal Disease

Published in:

01-09-2017 | Original Article

Safety of cold polypectomy for small colorectal neoplastic lesions: a prospective cohort study in Japan

Authors: Yuichi Shimodate, Motowo Mizuno, Rio Takezawa, Mami Kobayashi, Tatsuhiro Yamazaki, Akira Doi, Naoyuki Nishimura, Hirokazu Mouri, Kazuhiro Matsueda, Hiroshi Yamamoto

Published in: International Journal of Colorectal Disease | Issue 9/2017

Abstract

Background

Cold polypectomy has been widely accepted for removal of small colorectal polyps. However, no large-scale prospective study exists as for its safety in Japan. We investigated this issue in this single-center, prospective cohort study in a total of 1198 colorectal polyps resected with cold polypectomy.

Patients and methods

Four hundred and seventy-four patients who underwent cold polypectomy for colorectal neoplastic lesions less than 10-mm diameter between September 2014 and October 2016 were enrolled. Primary outcome was the incidence of delayed bleeding within 2 weeks after the procedure. Secondary outcomes were the rate of immediate bleeding, perforation, endoscopic en bloc resection, and advanced histology.

Results

Cold polypectomy was performed on 1198 polyps in the 474 patients. No delayed bleeding or colonic perforation was observed. Immediate bleeding during the procedure, requiring endoscopic hemostasis, occurred in 97 lesions (8.1%), and all of them were successfully managed endoscopically. The endoscopic en bloc resection rate was 97.2%. Twenty-eight lesions (2.3%) were histologically diagnosed as advanced neoplasia; among them, three lesions were well-differentiated adenocarcinomas, and in two of them, a negative margin was not histologically confirmed.

Conclusions

Cold polypectomy for small colorectal polyps is a safe technique without significant complication, but careful endoscopic diagnosis at cold polypectomy is necessary to identify advanced neoplasia. The reliability of cold polypectomy in excision of polyps with high-grade neoplasia should be established before the procedure becomes standard in the excision of small colorectal polyps.

Clinical trial registration number: UMIN000014812.

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Title: Safety of cold polypectomy for small colorectal neoplastic lesions: a prospective cohort study in Japan
Authors: Yuichi Shimodate
Motowo Mizuno
Rio Takezawa
Mami Kobayashi
Tatsuhiro Yamazaki
Akira Doi
Naoyuki Nishimura
Hirokazu Mouri
Kazuhiro Matsueda
Hiroshi Yamamoto
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 9/2017
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-017-2856-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Safety of cold polypectomy for small colorectal neoplastic lesions: a prospective cohort study in Japan

Abstract

Background

Patients and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusions

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