Academic Journal
Cold snare endoscopic resection for large colon polyps – a randomized trial
| العنوان: | Cold snare endoscopic resection for large colon polyps – a randomized trial |
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| المؤلفون: | Pohl, H., Rex, D. K, Barber, J., Moyer, M., Elmunzer, J., Rastogi, A., Gordon, Stuart C, Zolotarevsky, E., Levenick, J. M, Aslanian, H., ElAtrache, Mazen, Von Renteln, D., Bhaumik, B., Keswani, R., Kumta, N., Pleskow, D. K, Smith, Z., Abu Ghanimeh, M. K, Sanaei, O., Jensen, L. L, Mackenzie, T., Piraka, Cyrus |
| المصدر: | Gastroenterology Meeting Abstracts |
| بيانات النشر: | Henry Ford Health Scholarly Commons |
| سنة النشر: | 2024 |
| المجموعة: | Henry Ford Health System Scholarly Commons |
| الوصف: | Aims: Despite improvements in technique, severe adverse events (SAE), including post-procedure bleeding, remain a major concern following endoscopic resection of large colorectal polyps. We examined whether cold resection without the use of electrocautery reduces the risk of SAE and affords completeness of resection. Methods: We performed a multicenter, randomized trial of patients with a large nonpedunculated colon polyp (≥20 mm) at 10 medical centers in North America from October 2019 through January 2023. Patients were randomly assigned to endoscopic mucosal resection (EMR) without electrocautery (cold EMR group) or with electrocautery (hot EMR group) and were followed until their first surveillance colonoscopy. Hot EMR included margin treatment and defect closure as indicated. The primary outcome were SAEs in intention to treat analysis, defined as an event that required hospitalization, a blood transfusion, colonoscopy, surgery, or another invasive intervention within 30 days after completion of the colonoscopy. The secondary outcome was the rate of polyp recurrence at surveillance colonoscopy. Because crossover from cold to hot EMR was expected (assumed 10%), we also performed a per protocol analysis. Additional subgroup analysis considered polyp characteristics and use of periprocedural antithrombotic medications. Results: 660 patients were randomized, and 518 (78.5%) completed their first surveillance colonoscopy. Crossover occurred in 14.6% in the cold EMR group and in 13.4% in the hot EMR group. An SAE was observed in 2.1% of patients in the cold EMR group and in 4.3% in the hot EMR group (p=0.62) with postprocedure bleeding in 0.9% and 2.8%, respectively (p=0.52). When the analysis was restricted to patients who received the intervention as randomized (per protocol analysis), significantly fewer SAEs occurred in the cold EMR group as compared to the hot EMR group (1.4% vs 4.9%, p=0.017), with postprocedure bleeding in 1.1% and 2.5%, respectively (p=0.34). Polyp recurrence was detected in 28.0% in the ... |
| نوع الوثيقة: | text |
| اللغة: | unknown |
| Relation: | https://scholarlycommons.henryford.com/gastroenterology_mtgabstracts/220 |
| DOI: | 10.1055/s-0044-1782699&id=pmid:&sid=EBSCO:CINAHL&au=Pohl,%20H |
| الاتاحة: | https://scholarlycommons.henryford.com/gastroenterology_mtgabstracts/220 https://doi.org/10.1055/s-0044-1782699&id=pmid:&sid=EBSCO:CINAHL&au=Pohl,%20H |
| رقم الانضمام: | edsbas.210A27EE |
| قاعدة البيانات: | BASE |
| DOI: | 10.1055/s-0044-1782699&id=pmid:&sid=EBSCO:CINAHL&au=Pohl,%20H |
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