Background and Aims
Cold snare polypectomy (CSP) is associated with higher rates of complete resection
compared with cold biopsy forceps (CBF) for the removal of small polyps (4-9 mm).
This study aimed to evaluate self-reported polypectomy preferences and actual practice
patterns among endoscopists at an academic center and to identify factors associated
with the use of CSP for small polyps.
Methods
In phase A, endoscopists completed a survey evaluating preferences for polypectomy
techniques. In phase B, we performed a retrospective analysis of all consecutive colonoscopies
with polypectomy (January 2016 to September 2018). Uni- and multivariate analysis
were performed to identify factors associated with CSP for small polyps.
Results
Nineteen of 26 (73%) endoscopists completed the survey (phase A); 3 (15.8%) were interventional
endoscopists. Most respondents indicated that they use CSP (89.5%) for small polyps
and identified no reasons for choosing CBF over CSP (73.7%). In phase B, we identified
1118 colonoscopies with 2625 polypectomies for polyps ≤9 mm. Most diminutive polyps
(≤3 mm) were removed with CBF (819 of 912; 90%). CBF (46.2%) was also preferentially
used for removal of small polyps (n = 1713), followed by hot snare polypectomy (27.2%),
and CSP (26.6%). On multivariate analysis, interventional endoscopists were associated
with a higher likelihood of using CSP for small polyps (odds ratio, 1.38; 95% confidence
interval, 1.07-1.79; P = .01).
Conclusions
Significant discrepancy exists between self-reported preferences and actual polypectomy
practices. CBF is still preferentially used over CSP for the removal of polyps sized
4-9 mm; further strategies are needed to monitor and implement adequate polypectomy
techniques.
Abbreviations:
BMI (body mass index), CBF (cold biopsy forceps), CI (confidence interval), CRC (colorectal cancer), CSP (cold snare polypectomy), ESGE (European Society of Gastrointestinal Endoscopy), HSP (hot snare polypectomy), IQR (interquartile range), OR (odds ratio)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 26, 2019
Accepted:
October 13,
2019
Received:
August 7,
2019
Footnotes
DISCLOSURE: Dr Draganov is a consultant for Olympus, Lumendi, Boston Scientific, and Cook Medical. Dr Yang is a consultant for US Endoscopy, Boston Scientific, and Lumendi. All other authors disclosed no financial relationships.
Identification
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© 2020 by the American Society for Gastrointestinal Endoscopy
