Endoscopic features and clinical course of colorectal carcinoma resected by cold snare polypectomy
- 24 February 2023
- journal article
- research article
- Published by Wiley in Journal of Gastroenterology and Hepatology
- Vol. 38 (6), 948-954
- https://doi.org/10.1111/jgh.16145
Abstract
Background and AimCold snare polypectomy is commonly performed to remove small colorectal polyps. Accidental resection of carcinomas during this procedure has been reported. Herein, we aimed to clarify the clinicopathological features and clinical course of colorectal carcinomas resected by cold snare polypectomy. MethodsThis multicenter retrospective cohort study was conducted at 10 Japanese healthcare centers. Of the colorectal lesions resected by cold snare polypectomy between April 2016 and March 2020, lesions pathologically diagnosed as carcinoma were reviewed. Centralized histology (based on the Vienna classification) and endoscopic reviews were performed. The study endpoints were endoscopic features and clinical outcomes of cold snare polypectomy-resected colorectal carcinomas (Vienna category >= 4.2). ResultsWe reviewed 74 of the 70 693 lesions resected by cold snare polypectomy. After a central pathological review, 68 lesions were diagnosed as carcinomas. The Japan Narrow-band imaging Expert Team (JNET) classification type 2B, lesion size >= 6 mm, and multinodular morphology were the significant endoscopic predictors of carcinoma resected by cold snare polypectomy. No adverse events related to the procedure occurred. Sixty-three lesions were diagnosed as carcinomas within the mucosal layer, and 34 were curative resections. Of the five carcinoma lesions with submucosal invasion, additional surgery revealed remnant cancer tissues in one lesion. No local or metastatic recurrence was observed during follow-up. ConclusionsAlthough most of the carcinomas resected by cold snare polypectomy were within the mucosal layer, few lesions invading the submucosa were identified. Careful pre-procedural endoscopic evaluation, especially focusing on the JNET classification and multinodular morphology, is recommended.Keywords
This publication has 23 references indexed in Scilit:
- Narrow‐band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert TeamDigestive Endoscopy, 2016
- Characterization and significance of protrusions in the mucosal defect after cold snare polypectomyGastrointestinal Endoscopy, 2015
- Endoscopic features and management of diminutive colorectal submucosal invasive carcinomaDigestive Endoscopy, 2014
- Removal of small colorectal polyps in anticoagulated patients: a prospective randomized comparison of cold snare and conventional polypectomyGastrointestinal Endoscopy, 2013
- Prevalence of advanced histological features in diminutive and small colon polypsGastrointestinal Endoscopy, 2012
- Colonoscopic Polypectomy and Long-Term Prevention of Colorectal-Cancer DeathsThe New England Journal of Medicine, 2012
- CURRENT STATUS IN THE OCCURRENCE OF POSTOPERATIVE BLEEDING, PERFORATION AND RESIDUAL/LOCAL RECURRENCE DURING COLONOSCOPIC TREATMENT IN JAPANDigestive Endoscopy, 2010
- Polyp Size and Advanced Histology in Patients Undergoing Colonoscopy Screening: Implications for CT ColonographyGastroenterology, 2008
- The Vienna classification of gastrointestinal epithelial neoplasiaGut, 2000
- Prevention of Colorectal Cancer by Colonoscopic PolypectomyThe New England Journal of Medicine, 1993