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HOT VERSUS COLD SNARE FOR COLORECTAL POLYPECTOMIES SIZED UP TO 10MM: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
Cavassola, Paulo Ricardo Pavanatto; Moura, Diogo Turiani Hourneaux de; Hirsch, Bruno Salomão; Landim, Davi Lucena; Bernardo, Wanderley Marques; Moura, Eduardo Guimarães Hourneaux de.
Afiliación
  • Cavassola PRP; Faculdade de Medicina da Universidade de São Paulo Hospital das Clínicas, Departamento de Gastroenterologia, Serviço de Endoscopia Gastrointestinal, Sao Paulo, SP, Brasil.
  • Moura DTH; Faculdade de Medicina da Universidade de São Paulo Hospital das Clínicas, Departamento de Gastroenterologia, Serviço de Endoscopia Gastrointestinal, Sao Paulo, SP, Brasil.
  • Hirsch BS; Faculdade de Medicina da Universidade de São Paulo Hospital das Clínicas, Departamento de Gastroenterologia, Serviço de Endoscopia Gastrointestinal, Sao Paulo, SP, Brasil.
  • Landim DL; Faculdade de Medicina da Universidade de São Paulo Hospital das Clínicas, Departamento de Gastroenterologia, Serviço de Endoscopia Gastrointestinal, Sao Paulo, SP, Brasil.
  • Bernardo WM; Faculdade de Medicina da Universidade de São Paulo Hospital das Clínicas, Departamento de Gastroenterologia, Serviço de Endoscopia Gastrointestinal, Sao Paulo, SP, Brasil.
  • Moura EGH; Faculdade de Medicina da Universidade de São Paulo Hospital das Clínicas, Departamento de Gastroenterologia, Serviço de Endoscopia Gastrointestinal, Sao Paulo, SP, Brasil.
Arq Gastroenterol ; 61: e23143, 2024.
Article en En | MEDLINE | ID: mdl-38511795
ABSTRACT

BACKGROUND:

Colorectal cancer is the third most common cancer, and prevention relies on screening programs with resection complete resection of neoplastic lesions.

OBJECTIVE:

We aimed to evaluate the best snare polypectomy technique for colorectal lesions up to 10 mm, focusing on complete resection rate, and adverse events.

METHODS:

A comprehensive search using electronic databases was conducted to identify randomized controlled trials comparing hot versus cold snare resection for polyps sized up to 10 mm, and following PRISMA guidelines, a meta-analysis was performed. Outcomes included complete resection rate, en bloc resection rate, polypectomy, procedure times, immediate, delayed bleeding, and perforation.

RESULTS:

Nineteen RCTs involving 8720 patients and 17588 polyps were included. Hot snare polypectomy showed a higher complete resection rate (RD, 0.02; 95%CI [+0.00,0.04]; P=0.03; I 2=63%), but also a higher rate of delayed bleeding (RD 0.00; 95%CI [0.00, 0.01]; P=0.01; I 2=0%), and severe delayed bleeding (RD 0.00; 95%CI [0.00, 0.00]; P=0.04; I 2=0%). Cold Snare was associated with shorter polypectomy time (MD -46.89 seconds; 95%CI [-62.99, -30.79]; P<0.00001; I 2=90%) and shorter total colonoscopy time (MD -7.17 minutes; 95%CI [-9.10, -5.25]; P<0.00001; I 2=41%). No significant differences were observed in en bloc resection rate or immediate bleeding.

CONCLUSION:

Hot snare polypectomy presents a slightly higher complete resection rate, but, as it is associated with a longer procedure time and a higher rate of delayed bleeding compared to Cold Snare, it cannot be recommended as the gold standard approach. Individual analysis and personal experience should be considered when selecting the best approach.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Ensayos Clínicos Controlados Aleatorios como Asunto / Pólipos del Colon / Colonoscopía Límite: Humans Idioma: En Revista: Arq Gastroenterol Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Brasil
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Ensayos Clínicos Controlados Aleatorios como Asunto / Pólipos del Colon / Colonoscopía Límite: Humans Idioma: En Revista: Arq Gastroenterol Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Brasil