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Hot snare polypectomy vs endoscopic mucosal resection using bipolar snare for intermediate size colorectal lesions:Propensity score matching

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World Journal of Gastroenterology 2023年第23期29卷 3668-3677页

作者： Nobuhisa Minakata tatsuro murano Masashi Wakabayashi Maasa Sasabe Takashi Watanabe Tomohiro Mitsui Hiroki Yamashita Atsushi Inaba Hironori Sunakawa Keiichiro Nakajo Tomohiro Kadota Kensuke Shinmura Hiroaki Ikematsu Tomonori Yano Department of Gastroenterology and Endoscopy National Cancer Center Hospital EastKashiwa 2778577ChibaJapan Department of Biostatistics Division Center for Research Administration and SupportNational Cancer CenterKashiwa 2778577ChibaJapan

BACKGROUND Endoscopic resection(ER)with bipolar snare,in which the electric current only passes through the tissue between the device’s two electrodes,is a prominent method used to prevent perforation due to electricity *** using bipolar snare with or without submucosal injection enabled safe resection of colorectal lesions measuring 10-15 mm in an ex vivo porcine *** with bipolar snare is expected to have good treatment outcomes in 10-15 mm colorectal lesions,with high safety even without submucosal ***,no clinical reports have compared treatment outcomes with and without submucosal *** To compare the treatment outcomes of bipolar polypectomy with hot snare polypectomy(HSP)to those with endoscopic mucosal resection(EMR).METHODS In this single-centre retrospective study,we enrolled 10-15 mm nonpedunculated colorectal lesions(565 Lesions in 463 patients)diagnosed as type 2A based on the Japan Narrow-band Imaging Expert Team classification,resected by either HSP or EMR between January 2018 and June 2021 at the National Cancer Center Hospital *** were divided into HSP and EMR groups,and propensity score matching was *** the matched cohort,en bloc and R0 resection rates and adverse events were compared between the two *** Of the 565 lesions in 463 patients,117 lesions each in the HSP and EMR groups were selected after propensity score *** the original cohort,there was a significant difference in antithrombotic drug use(P<0.05),lesion size(P<0.01),location(P<0.01),and macroscopic type(P<0.05)between the HSP and EMR *** the matched cohort,the en bloc resection rates were comparable between both groups[93.2%(109/117)vs 92.3%(108/117),P=0.81],and there was no significant difference in the R0 resection rate[77.8%(91/117)vs 80.3%(94/117),P=0.64].The incidence of delayed bleeding was similar in both groups[1.7%(2/117)].Perforation occurred in the EMR group[0.9%(1/117)]but not in the HSP ***

关键词： Adenoma Cohort studies Colonoscopy Colorectal cancer Endoscopic mucosal resection Treatment outcome

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