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Comparison of thin vs. thick wire snares for cold-snare polypectomy

Colorectal polyps Colorectal polyps
Colorectal polyps Colorectal polyps

The effectiveness of thin vs. thick-wire snares in cold-snare polypectomy (CSP) for the resection of small colorectal polyps (≤10 mm) has been debated. This meta-analysis aimed to clarify which snare type offers better outcomes with fewer adverse effects.

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Key take away

Whether using thin-wire or thick-wire snares, cold-snare polypectomy is equally effective and safe for removing small colorectal polyps.

Background

The effectiveness of thin vs. thick-wire snares in cold-snare polypectomy (CSP) for the resection of small colorectal polyps (≤10 mm) has been debated. This meta-analysis aimed to clarify which snare type offers better outcomes with fewer adverse effects.

Method

Data from two observational studies and four randomized controlled trials involving 1,316 patients and 1,679 polyps (≧1 and ≦10 mm) treated with thin-wire or thick-wire snares were incorporated. The key outcome included complete resection (CR) rate while secondary outcomes included polyp retrieval, intraprocedural or post-polypectomy bleeding, deep mural injury, procedure time, patient discomfort, and total sedation.  Investigators used random-effects models to calculate risk ratios, assessed bias, rated evidence certainty, and checked for publication bias.

Result

No significant differences were found between thin-wire and thick-wire snares for CR rates in RCTs (92.1% vs. 87.7%)  or observational studies (78.1% vs. 79.6%). Both snare types showed similar results for polyp retrieval and intraprocedural bleeding. No instances of delayed bleeding or perforation were reported.

Conclusion

CSP is safe and effective for endoscopic resection of small colorectal polyps, regardless of snare type.

Source:

Endoscopy International Open

Article:

Effectiveness and safety of thin vs. thick cold snare polypectomy of small colorectal polyps: Systematic review and meta-analysis

Authors:

Rishad Khan et. al.

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