Cold polypectomy techniques for diminutive polyps in the colorectum

Adequate colonoscopic polypectomy is a very important intervention for the prevention of colorectal cancer progression during screening and surveillance colonoscopy. Whereas various techniques are used for the removal of diminutive polyps, including cold biopsy forceps, hot biopsy forceps, hot snare, and cold snare, hot polypectomy techniques with electrocautery have been associated with an increased risk of electrocautery‐related complications, including immediate and/or delayed bleeding or perforation. In contrast, recent studies have found a polypectomy technique without electrocautery, so‐called cold polypectomy, to be a safer and more efficacious technique. The present article discusses the use of cold polypectomy techniques and describes how cold biopsy forceps polypectomy using jumbo biopsy forceps designed with a greater capacity for removing larger tissue samples, and cold snare polypectomy, are adequate for removing diminutive polyps completely and safely and shorten withdrawal time of the colonoscopy procedure.

[1]  D. Graham,et al.  Removal of small colorectal polyps in anticoagulated patients: a prospective randomized comparison of cold snare and conventional polypectomy. , 2014, Gastrointestinal endoscopy.

[2]  J. Shim,et al.  Cold Snare Polypectomy Vs. Cold Forceps Polypectomy Using Double-Biopsy Technique for Removal of Diminutive Colorectal Polyps: A Prospective Randomized Study , 2013, The American Journal of Gastroenterology.

[3]  D. Hewett.  Colonoscopic polypectomy: current techniques and controversies. , 2013, Gastroenterology clinics of North America.

[4]  Y. Cho,et al.  Complete biopsy resection of diminutive polyps , 2013, Endoscopy.

[5]  Y. Sano,et al.  Tu1502 Polypectomy Using Jumbo Biopsy Forceps for Small Colorectal Polyps: a Multi-Center Prospective Trial , 2013 .

[6]  A. Horiuchi,et al.  852 Prospective Randomized Comparison of Cold SNARE Polypectomy and Conventional Polypectomy for Small Colorectal Polyps in Patients Receiving Anticoagulation Therapy , 2013 .

[7]  M. Bourke,et al.  A blinded comparison of the safety and efficacy of hot biopsy forceps electrocauterization and conventional snare polypectomy for diminutive colonic polypectomy in a porcine model. , 2013, Gastrointestinal endoscopy.

[8]  M. Krinsky,et al.  Quality of Polyp Resection During Colonoscopy: Are We Achieving Polyp Clearance? , 2012, Digestive Diseases and Sciences.

[9]  A. Zauber,et al.  Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. , 2012, The New England journal of medicine.

[10]  A. Zullo,et al.  Safety of cold polypectomy for < 10 mm polyps at colonoscopy: a prospective multicenter study , 2011, Endoscopy.

[11]  G. Paspatis,et al.  A prospective randomized comparison of cold vs hot snare polypectomy in the occurrence of postpolypectomy bleeding in small colonic polyps , 2011, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[12]  A. Horiuchi,et al.  Prospective Randomized Comparison of Cold Snare Polypectomy and Conventional Polypectomy for Small Colorectal Polyps , 2011, Digestion.

[13]  S. Kudo,et al.  MID‐TERM PROGNOSIS AFTER ENDOSCOPIC RESECTION FOR SUBMUCOSAL COLORECTAL CARCINOMA: SUMMARY OF A MULTICENTER QUESTIONNAIRE SURVEY CONDUCTED BY THE COLORECTAL ENDOSCOPIC RESECTION STANDARDIZATION IMPLEMENTATION WORKING GROUP IN JAPANESE SOCIETY FOR CANCER OF THE COLON AND RECTUM , 2011, Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society.

[14]  P. Desmond,et al.  Biopsy forceps is inadequate for the resection of diminutive polyps. , 2011, Endoscopy.

[15]  D. Rex,et al.  A survey of colonoscopic polypectomy practices among clinical gastroenterologists. , 2004, Gastrointestinal endoscopy.

[16]  A. Zauber,et al.  Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. , 1993 .

[17]  M. Kimmey,et al.  Status evaluation: hot biopsy forceps. American Society for Gastrointestinal Endoscopy. Technology Assessment Committee. , 1992, Gastrointestinal endoscopy.

[18]  D. Rex,et al.  Colonoscopy and endoscopic therapy for delayed post-polypectomy hemorrhage. , 1992, Gastrointestinal endoscopy.

[19]  Mihir S. Wagh,et al.  Randomized, controlled trial of standard, large-capacity versus jumbo biopsy forceps for polypectomy of small, sessile, colorectal polyps. , 2012, Gastrointestinal endoscopy.

[20]  R. Fujita,et al.  Hemoclipping for postpolypectomy and postbiopsy colonic bleeding. , 2000, Gastrointestinal endoscopy.

[21]  R. Sanowski,et al.  Complications of the hot biopsy forceps technique. , 1988, Gastrointestinal endoscopy.