TY - JOUR
T1 - Cold snare versus cold forceps polypectomy for endoscopic resection of diminutive polyps
T2 - meta-analysis of randomized controlled trials
AU - Kamal, Faisal
AU - Khan, Muhammad Ali
AU - Lee-Smith, Wade
AU - Sharma, Sachit
AU - Acharya, Ashu
AU - Farooq, Umer
AU - Agarwal, Amit
AU - Aziz, Muhammad
AU - Chuang, Justin
AU - Kumar, Anand
AU - Schlachterman, Alexander
AU - Loren, David
AU - Kowalski, Thomas
AU - Adler, Douglas
N1 - Publisher Copyright:
© 2023 American Society for Gastrointestinal Endoscopy
PY - 2023/7
Y1 - 2023/7
N2 - Background and Aims: The practices for resection of diminutive colon polyps vary among endoscopists, and U.S. Multi-Society Task force guidelines recommend use of cold snare polypectomy (CSP) for this purpose. In this meta-analysis, we compared CSP and cold forceps polypectomy (CFP) for resection of diminutive polyps. Methods: Several databases were reviewed to identify randomized controlled trials that compared CSP and CFP for resection of diminutive polyps. The study outcomes of interest were complete resection of all diminutive polyps, complete resection of polyps ≤3 mm in size, failure of tissue retrieval, and polypectomy time. For categorical variables, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated; for continuous variables, mean differences (MDs) with 95% CIs were calculated. Data were analyzed by using a random-effects model, and heterogeneity was assessed by using the I2 statistic. Results: We included 9 studies with 1037 patients. Rate of complete resection of all diminutive polyps was significantly higher in the CSP group (OR, 1.68; 95% CI, 1.09-2.58). Subgroup analysis, including jumbo or large-capacity forceps, found no significant difference in complete resection between groups (OR, 1.43; 95% CI,.80-2.56). We found no significant between-groups in the rates of complete resection of polyps ≤3 mm in size (OR,.83; 95% CI,.30-2.31). Rate of failure of tissue retrieval was significantly higher in the CSP group (OR, 10.13; 95% CI, 2.29-44.74). No significant between-group difference was noted in polypectomy time. Conclusions: CFP using large-capacity or jumbo biopsy forceps is noninferior to CSP for complete resection of diminutive polyps.
AB - Background and Aims: The practices for resection of diminutive colon polyps vary among endoscopists, and U.S. Multi-Society Task force guidelines recommend use of cold snare polypectomy (CSP) for this purpose. In this meta-analysis, we compared CSP and cold forceps polypectomy (CFP) for resection of diminutive polyps. Methods: Several databases were reviewed to identify randomized controlled trials that compared CSP and CFP for resection of diminutive polyps. The study outcomes of interest were complete resection of all diminutive polyps, complete resection of polyps ≤3 mm in size, failure of tissue retrieval, and polypectomy time. For categorical variables, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated; for continuous variables, mean differences (MDs) with 95% CIs were calculated. Data were analyzed by using a random-effects model, and heterogeneity was assessed by using the I2 statistic. Results: We included 9 studies with 1037 patients. Rate of complete resection of all diminutive polyps was significantly higher in the CSP group (OR, 1.68; 95% CI, 1.09-2.58). Subgroup analysis, including jumbo or large-capacity forceps, found no significant difference in complete resection between groups (OR, 1.43; 95% CI,.80-2.56). We found no significant between-groups in the rates of complete resection of polyps ≤3 mm in size (OR,.83; 95% CI,.30-2.31). Rate of failure of tissue retrieval was significantly higher in the CSP group (OR, 10.13; 95% CI, 2.29-44.74). No significant between-group difference was noted in polypectomy time. Conclusions: CFP using large-capacity or jumbo biopsy forceps is noninferior to CSP for complete resection of diminutive polyps.
KW - Colorectal Neoplasms/pathology
KW - Humans
KW - Colonoscopy
KW - Colonic Polyps/surgery
KW - Surgical Instruments
KW - Randomized Controlled Trials as Topic
UR - http://www.scopus.com/inward/record.url?scp=85162138585&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2023.03.008
DO - 10.1016/j.gie.2023.03.008
M3 - Review article
C2 - 36907527
AN - SCOPUS:85162138585
SN - 0016-5107
VL - 98
SP - 7-18.e4
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 1
ER -