Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial
Background/Aims Small polyps are the most frequently detected lesions during colonoscopy, with an incomplete resection rate of 6.8% to 15.9%. This study aimed to improve small polyp cold snare resection radicality using submucosal contrast dye pre-lifting (PL+CSP). Methods This single-center, prospe...
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Korean Society of Gastrointestinal Endoscopy
2025-03-01
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| Series: | Clinical Endoscopy |
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| Online Access: | http://e-ce.org/upload/pdf/ce-2024-113.pdf |
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| author | Ramona Schiumerini Paola Baccarini Adele Fornelli Davide Allegri Francesca Lodato Alessia Gazzola Pasquale Apolito Nunzio P. Longo Anna M. Polifemo Franca Patrizi Federica Buonfiglioli Stefania Ghersi Marco Bassi Liza Ceroni Antonella Ghetti Giulio Fonti Vincenzo Cennamo |
| author_facet | Ramona Schiumerini Paola Baccarini Adele Fornelli Davide Allegri Francesca Lodato Alessia Gazzola Pasquale Apolito Nunzio P. Longo Anna M. Polifemo Franca Patrizi Federica Buonfiglioli Stefania Ghersi Marco Bassi Liza Ceroni Antonella Ghetti Giulio Fonti Vincenzo Cennamo |
| author_sort | Ramona Schiumerini |
| collection | DOAJ |
| description | Background/Aims Small polyps are the most frequently detected lesions during colonoscopy, with an incomplete resection rate of 6.8% to 15.9%. This study aimed to improve small polyp cold snare resection radicality using submucosal contrast dye pre-lifting (PL+CSP). Methods This single-center, prospective, randomized controlled trial compared the standard cold snare polypectomy technique (PL-CSP) with PL+CSP to evaluate endoscopic and histological complete resection rates, adverse events, procedural times, and polyp retrieval failure rates. Results: In 143 patients consecutively enrolled, 186 small polyps were detected and randomly assigned following a 1:1 ratio to the PL-CSP (n=97, 51.6%) and PL+CSP (n=90, 48.4%) techniques. Endoscopic (p=0.97) and histologic (p=0.23) complete resection rates did not differ significantly even in univariate analysis. The intraprocedural bleeding rate was significantly higher in the PL+CSP group as confirmed by the univariate analysis (35.8% vs. 8.3%, p<0.001). The polyps retrieval failure rates were similar (p=0.83). Procedural time was significantly longer for PL+CSP (median time, 75 vs. 45 seconds; p<0.001), without impacting colonoscopy withdrawal time (p=0.215). Conclusions: PL+CSP of small polyps did not improve endoscopic and histological complete resection rates and polyp sample retrieval. PL+CSP had higher rates of intraprocedural bleeding and was “time-consuming”. |
| format | Article |
| id | doaj-art-d26b5447d0bb41b68f0f61721c9d841a |
| institution | OA Journals |
| issn | 2234-2400 2234-2443 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj-art-d26b5447d0bb41b68f0f61721c9d841a2025-08-20T01:51:39ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432025-03-0158229130210.5946/ce.2024.1137948Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trialRamona Schiumerini0Paola Baccarini1Adele Fornelli2Davide Allegri3Francesca Lodato4Alessia Gazzola5Pasquale Apolito6Nunzio P. Longo7Anna M. Polifemo8Franca Patrizi9Federica Buonfiglioli10Stefania Ghersi11Marco Bassi12Liza Ceroni13Antonella Ghetti14Giulio Fonti15Vincenzo Cennamo16 Complex Gastroenterology Department, Ospedale Maggiore, Bologna, Italy Pathology Department, Ospedale Bellaria, Bologna, Italy Pathology Department, Ospedale Maggiore, Bologna, Italy Clinical Governance Department, Azienda Unità Sanitaria Locale (AUSL) Bologna, Italy Complex Gastroenterology Department, Ospedale Maggiore, Bologna, Italy Complex Gastroenterology Department, Ospedale Maggiore, Bologna, Italy Complex Gastroenterology Department, Ospedale Maggiore, Bologna, Italy Complex Gastroenterology Department, Ospedale Maggiore, Bologna, Italy Complex Gastroenterology Department, Ospedale Maggiore, Bologna, Italy Complex Gastroenterology Department, Ospedale Maggiore, Bologna, Italy Complex Gastroenterology Department, Ospedale Maggiore, Bologna, Italy Complex Gastroenterology Department, Ospedale Maggiore, Bologna, Italy Complex Gastroenterology Department, Ospedale Maggiore, Bologna, Italy Complex Gastroenterology Department, Ospedale Maggiore, Bologna, Italy Complex Gastroenterology Department, Ospedale Maggiore, Bologna, Italy Complex Gastroenterology Department, Ospedale Maggiore, Bologna, Italy Complex Gastroenterology Department, Ospedale Maggiore, Bologna, ItalyBackground/Aims Small polyps are the most frequently detected lesions during colonoscopy, with an incomplete resection rate of 6.8% to 15.9%. This study aimed to improve small polyp cold snare resection radicality using submucosal contrast dye pre-lifting (PL+CSP). Methods This single-center, prospective, randomized controlled trial compared the standard cold snare polypectomy technique (PL-CSP) with PL+CSP to evaluate endoscopic and histological complete resection rates, adverse events, procedural times, and polyp retrieval failure rates. Results: In 143 patients consecutively enrolled, 186 small polyps were detected and randomly assigned following a 1:1 ratio to the PL-CSP (n=97, 51.6%) and PL+CSP (n=90, 48.4%) techniques. Endoscopic (p=0.97) and histologic (p=0.23) complete resection rates did not differ significantly even in univariate analysis. The intraprocedural bleeding rate was significantly higher in the PL+CSP group as confirmed by the univariate analysis (35.8% vs. 8.3%, p<0.001). The polyps retrieval failure rates were similar (p=0.83). Procedural time was significantly longer for PL+CSP (median time, 75 vs. 45 seconds; p<0.001), without impacting colonoscopy withdrawal time (p=0.215). Conclusions: PL+CSP of small polyps did not improve endoscopic and histological complete resection rates and polyp sample retrieval. PL+CSP had higher rates of intraprocedural bleeding and was “time-consuming”.http://e-ce.org/upload/pdf/ce-2024-113.pdfcolonoscopydiagnostic techniquedigestive systemhistological techniques |
| spellingShingle | Ramona Schiumerini Paola Baccarini Adele Fornelli Davide Allegri Francesca Lodato Alessia Gazzola Pasquale Apolito Nunzio P. Longo Anna M. Polifemo Franca Patrizi Federica Buonfiglioli Stefania Ghersi Marco Bassi Liza Ceroni Antonella Ghetti Giulio Fonti Vincenzo Cennamo Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial Clinical Endoscopy colonoscopy diagnostic technique digestive system histological techniques |
| title | Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial |
| title_full | Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial |
| title_fullStr | Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial |
| title_full_unstemmed | Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial |
| title_short | Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial |
| title_sort | impact of contrast dye submucosal pre lifting on cold snare resection of small polyps an italian randomized observational trial |
| topic | colonoscopy diagnostic technique digestive system histological techniques |
| url | http://e-ce.org/upload/pdf/ce-2024-113.pdf |
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