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Outcomes of thin versus thick-wire snares for cold snare polypectomy: a systematic review and meta-analysis

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Background/Aims: Cold snare polypectomy (CSP) is commonly used for the resection of colorectal polyps ≤10 mm. Data regardingthe influence of snare type on CSP effectiveness are conflicting. Hence, this meta-analysis aimed to compare the outcomes and safety ofthin- and thick-wire snares for CSP. Methods: A comprehensive search of the literature published between 2000 and 2021 was performed of various databases for compara-tive studies evaluating the outcomes of thin- versus thick-wire snares for CSP. Results: Five studies with data on 1,425 polyps were included in the analysis. The thick-wire snare was comparable to the thin-wiresnare with respect to complete histological resection (risk ratio [RR], 1.03; 95% confidence interval [CI], 0.97–1.09), overall bleeding(RR, 0.98; 95% CI, 0.40–2.40), polyp retrieval (RR, 1.01; 95% CI, 0.97–1.04), and involvement of submucosa in the resection specimen(RR, 1.28; 95% CI, 0.72–2.28). There was no publication bias and a small study effect, and the relative effects remained the same in thesensitivity analysis. Conclusions: CSP using a thin-wire snare has no additional benefit over thick-wire snares in small colorectal polyps. Factors otherthan snare design may play a role in improving CSP outcomes.

Abstract

Background/Aims: Cold snare polypectomy (CSP) is commonly used for the resection of colorectal polyps ≤10 mm. Data regardingthe influence of snare type on CSP effectiveness are conflicting. Hence, this meta-analysis aimed to compare the outcomes and safety ofthin- and thick-wire snares for CSP. Methods: A comprehensive search of the literature published between 2000 and 2021 was performed of various databases for compara-tive studies evaluating the outcomes of thin- versus thick-wire snares for CSP. Results: Five studies with data on 1,425 polyps were included in the analysis. The thick-wire snare was comparable to the thin-wiresnare with respect to complete histological resection (risk ratio [RR], 1.03; 95% confidence interval [CI], 0.97–1.09), overall bleeding(RR, 0.98; 95% CI, 0.40–2.40), polyp retrieval (RR, 1.01; 95% CI, 0.97–1.04), and involvement of submucosa in the resection specimen(RR, 1.28; 95% CI, 0.72–2.28). There was no publication bias and a small study effect, and the relative effects remained the same in thesensitivity analysis. Conclusions: CSP using a thin-wire snare has no additional benefit over thick-wire snares in small colorectal polyps. Factors otherthan snare design may play a role in improving CSP outcomes.

참고문헌 (29)

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