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)
- Zauber AG, "Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths", N Engl J Med, 366, pp.687~696 (2012)
- Lowenfels AB, "Determinants of polyp size in patients undergoing screening colonoscopy", BMC Gastroenterol, 11, pp.101~ (2011)
- Lieberman DA, "Prevalence of colon polyps detected by colonoscopy screening in asymptomatic black and white patients", JAMA, 300, pp.1417~1422 (2008)
- Burgess NG, "Risk factors for intraprocedural and clinically significant delayed bleeding after wide-field endoscopic mucosal resection of large colonic lesions", Clin Gastroenterol Hepatol, 12, pp.651~661 (2014)
- Kaltenbach T, "Endoscopic removal of colorectal lesions-recommendations by the US Multi-Society Task Force on Colorectal Cancer", Gastrointest Endosc, 91, pp.486~519 (2020)
- Ferlitsch M, "Colorectal polypectomy and endoscopic mucosal resection(EMR) : European Society of Gastrointestinal Endoscopy(ESGE)Clinical Guideline", Endoscopy, 49, pp.270~297 (2017)
- Takamaru H, "Comparison of postpolypectomy bleeding events between cold snare polypectomy and hot snare polypectomy for small colorectal lesions : a large-scale propensity score-matched analysis", Gastrointest Endosc, 95, pp.982~989 (2022)
- Brenner H, "Colorectal cancers occurring after colonoscopy with polyp detection : sites of polyps and sites of cancers", Int J Cancer, 133, pp.1672~1679 (2013)
- Humphris JL, "Cold snare polypectomy for diminutive polyps : an assessment of the risk of incomplete removal of small adenomas", Gastrointest Endosc, 69, pp.AB207~ (2009)
- Gonzalez I, "Quality colonoscopy : midterm results of a qualitative comparison of cold snare versus cold biopsy forceps for the resection of colonic polyps", Gastrointest Endosc, 71, pp.AB244~ (2010)
- de Benito Sanz M, "Efficacy and safety of cold versus hot snare polypectomy for small(5-9 mm)colorectal polyps : a multicenter randomized controlled trial", Endoscopy, 54, pp.35~44 (2022)
- Ouzzani M, "Rayyan-a web and mobile app for systematic reviews", Syst Rev, 5, pp.210~ (2016)
- Higgins JP, "The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials", BMJ, 343, pp.d5928~ (2011)
- Sterne JA, "ROBINS-I : a tool for assessing risk of bias in non-randomised studies of interventions", BMJ, 355, pp.i4919~ (2016)
- Puhan MA, "A GRADE Working Group approach for rating the quality of treatment effect estimates from network meta-analysis", BMJ, 349, pp.g5630~ (2014)
- Page MJ, "The PRISMA 2020 statement : an updated guideline for reporting systematic reviews", BMJ, 372, pp.n71~ (2021)
- Din S, "Cold snare polypectomy : does snare type influence outcomes?", Dig Endosc, 27, pp.603~608 (2015)
- Horiuchi A, "Prospective, randomized comparison of 2 methods of cold snare polypectomy for small colorectal polyps", Gastrointest Endosc, 82, pp.686~692 (2015)
- Dwyer JP, "A prospective comparison of cold snare polypectomy using traditional or dedicated cold snares for the resection of small sessile colorectal polyps", Endosc Int Open, 5, pp.E1062~E1068 (2017)
- Jung Y, "Comparison of the clinical efficacy of the cold snare polypectomy using a thin wire mini-snare and thick wire mini-snare for small sized colorectal polyps", Gastrointest Endosc, 87, pp.AB366~ (2018)
- Sidhu M, "A randomized controlled trial of cold snare polypectomy technique : technique matters more than snare wire diameter", Am J Gastroenterol, 117, pp.100~ (2022)
- Pohl H, "Incomplete polyp resection during colonoscopy-results of the complete adenoma resection(CARE)study", Gastroenterology, 144, pp.74~80 (2013)
- 이상표, "Risk Factors for Incomplete Polyp Resection during Colonoscopic Polypectomy", Gut and Liver, 9(1), pp.66~72 (2015), 거트앤리버 소화기연관학회협의회
- Pedersen IB, "Incomplete endoscopic resection of colorectal polyps : a prospective quality assurance study", Endoscopy, 53, pp.383~391 (2021)
- Saito S, "Serrated polyps of the colon and rectum : endoscopic features including image enhanced endoscopy", World J Gastrointest Endosc, 7, pp.860~871 (2015)
- Pohl H, "Recurrence of colorectal neoplastic polyps after incomplete resection", Ann Intern Med, 174, pp.1377~1384 (2021)
- ASGE Technology Committee, "ASGE Technology Committee systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting real-time endoscopic assessment of the histology of diminutive colorectal polyps", Gastrointest Endosc, 81, pp.502~ (2015)
- Bendall O, "Delayed bleeding after endoscopic resection of colorectal polyps : identifying high-risk patients", Clin Exp Gastroenterol, 14, pp.477~492 (2021)
- Jung YS, "Comparative efficacy of cold polypectomy techniques for diminutive colorectal polyps : a systematic review and network meta-analysis", Surg Endosc, 32, pp.1149~1159 (2018)
