RESUMEN
Background and study aim Cold resection is becoming the standard of care for the resection of nonpedunculated colon lesions up to 10âmm in diameter. Sessile serrated adenomas/polyps (SSA/Ps), including thoseâ≥â10âmm, present various characteristics that make them ideal candidates for cold snare polypectomy (CSP). Patients and methods A prospectively maintained database was searched retrospectively for consecutive patients with lesionsâ≥â10âmm resected between March 2013 and March 2018.âDuring that period, all SSA/P-appearing lesions were resected using CSP without submucosal injection, except for lesions with endoscopic suspicion of dysplasia or submucosal invasion. Patients with a pathological diagnosis of SSA/P were included in the analysis. Adverse events were recorded up to 21 days following colonoscopy. Results 615 SSA/Ps ≥â10âmm were resected during 452 colonoscopy procedures in 379 patients (mean age 54.1 years; standard deviation [SD] 11.9 years). Mean polyp size was 13.7 (SD 5.2) mm; 122 lesions (19.8â%) were ≥â20âmm and 479 lesions (77.9â%) underwent piecemeal resection. Immediate adverse events included persistent abdominal pain that resolved spontaneously within 2 hours in three patients (0.8â%; 95â% confidence interval [CI] 0.2â%-2.3â%). One patient with persistent intraprocedural bleeding was successfully treated with a hemostatic clip.âNo late adverse events were detected. Surveillance colonoscopy was performed in 293 patients (77.3â%) at 23.4 (SD 11.6) months following index colonoscopy; residual/recurrent lesions were diagnosed in 23 patients (7.8â%; 95â%CI 5.0â%-11.6â%). Conclusion CSP without submucosal injection appeared to be safe and effective for the resection of large SSA/Ps.