Cold snare versus cold forceps polypectomy for endoscopic resection of diminutive polyps: meta-analysis of randomized controlled trials.

Authors

• Faisal Kamal
• Muhammad Ali Khan
• Wade Lee-Smith
• Sachit Sharma
• Ashu Acharya
• Umer Farooq
• Amit Agarwal
• Muhammad Aziz
• Justin Chuang
• Anand Kumar
• Alexander Schlachterman
• David Loren
• Thomas Kowalski
• Douglas Adler

Publication/Presentation Date

7-1-2023

Abstract

BACKGROUND AND AIMS: The practices for resection of diminutive colon polyps vary among endoscopists, and U.S. Multi-Society Task force guidelines recommend use of cold snare polypectomy (CSP) for this purpose. In this meta-analysis, we compared CSP and cold forceps polypectomy (CFP) for resection of diminutive polyps.

METHODS: Several databases were reviewed to identify randomized controlled trials that compared CSP and CFP for resection of diminutive polyps. The study outcomes of interest were complete resection of all diminutive polyps, complete resection of polyps ≤3 mm in size, failure of tissue retrieval, and polypectomy time. For categorical variables, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated; for continuous variables, mean differences (MDs) with 95% CIs were calculated. Data were analyzed by using a random-effects model, and heterogeneity was assessed by using the I

RESULTS: We included 9 studies with 1037 patients. Rate of complete resection of all diminutive polyps was significantly higher in the CSP group (OR, 1.68; 95% CI, 1.09-2.58). Subgroup analysis, including jumbo or large-capacity forceps, found no significant difference in complete resection between groups (OR, 1.43; 95% CI, .80-2.56). We found no significant between-groups in the rates of complete resection of polyps ≤3 mm in size (OR, .83; 95% CI, .30-2.31). Rate of failure of tissue retrieval was significantly higher in the CSP group (OR, 10.13; 95% CI, 2.29-44.74). No significant between-group difference was noted in polypectomy time.

CONCLUSIONS: CFP using large-capacity or jumbo biopsy forceps is noninferior to CSP for complete resection of diminutive polyps.

Volume

98

Issue

1

First Page

7

Last Page

18

ISSN

1097-6779

Published In/Presented At

Kamal, F., Khan, M. A., Lee-Smith, W., Sharma, S., Acharya, A., Farooq, U., Agarwal, A., Aziz, M., Chuang, J., Kumar, A., Schlachterman, A., Loren, D., Kowalski, T., & Adler, D. (2023). Cold snare versus cold forceps polypectomy for endoscopic resection of diminutive polyps: meta-analysis of randomized controlled trials. Gastrointestinal endoscopy, 98(1), 7–18.e4. https://doi.org/10.1016/j.gie.2023.03.008

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

36907527

Department(s)

Administration and Leadership

Document Type

Article