Is jumbo biopsy forceps comparable to cold snare for diminutive colorectal polyps? – a meta-analysis
Open Access
- 1 January 2021
- journal article
- research article
- Published by Georg Thieme Verlag KG in Endoscopy International Open
- Vol. 09 (01), E9-E13
- https://doi.org/10.1055/a-1293-6965
Abstract
Background and study aims Diminutive colorectal polyps are increasingly being detected and it is not clear whether jumbo biopsy forceps (JBF) has comparable efficacy to that of cold snare polypectomy (CSP) for management of these lesions. Methods An electronic literature search was performed for studies comparing resection rates of JBF and CSP for diminutive polyps (≤ 5 mm). The primary outcome was incomplete resection rate (IRR). Secondary outcomes included failure of tissue retrieval and complication rates (post-polypectomy bleeding, perforation etc.). Leave-one-out analysis was performed to examine the disproportionate role of any of the studies. Meta-analysis outcomes and heterogeneity (I2) were computed using Comprehensive meta-analysis software. Results A total of 4 studies (3 randomized controlled trials and 1 retrospective study) with 407 patients and 569 total polyps (mean size of 3.62 mm) was included for analysis. IRR of JBF was slightly higher than that of CSP (10.2 % vs 7.2 %) but this was not statistically significantly different (Pooled OR 1.76; 95 % CI 0.94–3.28; I2 = 0). Leave-one-out analysis showed no significant difference in the pooled OR comparison either. Two of the 4 studies reported 0 % failure of tissue retrieval for JBF and 1 % and 4.3 % for CSP. There were no complications for either group from the 2 studies that reported this outcome. The quality of the included studies was moderate to high. Conclusions This systematic review with only limited data shows that JBF and CSP are not statistically different in completely removing diminutive polyps, although careful endoscopic assessment is needed to ensure complete removal of all polyp tissue. Received: 04 May 2020 Accepted: 29 September 2020 Publication Date: 01 January 2021 (online) © 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyThis publication has 14 references indexed in Scilit:
- Risk of cancer in small and diminutive colorectal polypsDigestive and Liver Disease, 2016
- Role of the cold biopsy technique in diminutive and small colonic polyp removal: a systematic review and meta-analysisGastrointestinal Endoscopy, 2016
- Cold Snare Polypectomy Vs. Cold Forceps Polypectomy Using Double-Biopsy Technique for Removal of Diminutive Colorectal Polyps: A Prospective Randomized StudyThe American Journal of Gastroenterology, 2013
- Incomplete Polyp Resection During Colonoscopy—Results of the Complete Adenoma Resection (CARE) StudyGastroenterology, 2013
- Quality of Polyp Resection During Colonoscopy: Are We Achieving Polyp Clearance?Digestive Diseases and Sciences, 2012
- Randomized, controlled trial of standard, large-capacity versus jumbo biopsy forceps for polypectomy of small, sessile, colorectal polypsGastrointestinal Endoscopy, 2012
- The Cochrane Collaboration's tool for assessing risk of bias in randomised trialsBMJ, 2011
- M1523: Quality Colonoscopy: Midterm Results of a Qualitative Comparison of Cold Snare Versus Cold Biopsy Forceps for the Resection of Colonic PolypsGastrointestinal Endoscopy, 2010
- Ongoing colorectal cancer risk despite surveillance colonoscopy: the Polyp Prevention Trial Continued Follow-up StudyGastrointestinal Endoscopy, 2010