Cold snare polypectomy for colorectal polyps: endoscopical and histological outcomes

Khalin K.D.

Clinical Hospital RZD-Medicine;
Pacific State Medical University

Ogurchyenok N.E.

Clinical Hospital RZD-Medicine

Agapov M.Y.

City Clinical Oncology Hospital

ORCID: 0000-0002-6322-6782

Zvereva L.V.

Clinical Hospital RZD-Medicine

Stegniy K.V.

Pacific State Medical University

Cold snare polypectomy for colorectal polyps: endoscopical and histological outcomes

Authors:

Khalin K.D., Ogurchyenok N.E., Agapov M.Y., Zvereva L.V., Stegniy K.V.

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Journal: Russian Journal of Evidence-Based Gastroenterology. 2020;9(4): 25‑32

DOI: 10.17116/dokgastro2020904125

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To cite this article:

Khalin KD, Ogurchyenok NE, Agapov MY, Zvereva LV, Stegniy KV. Cold snare polypectomy for colorectal polyps: endoscopical and histological outcomes. Russian Journal of Evidence-Based Gastroenterology. 2020;9(4):25‑32. (In Russ.)
https://doi.org/10.17116/dokgastro2020904125

Подписка 2025-2 (Russian Journal of Evidence-Based Gastroenterology)

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BACKGROUND

Large colon polyps should be fixed by pins on any hard substrate after endoscopic resection. Small polyps are suggested to put on adhesive paper before placement in formalin or even without any fixation.

AIM

To analyze the results of cold snare polypectomies and quality of pathology report after specimens fixation by pins.

METHODS

From 2017 December to 2020 March there were 350 cold snare polypectomies at 180 patients (female — 119) without any complications. Average age — 62.9 years. 160 polyps (45.7%) were fixed with pins before formalin immersion. 190 polyps were immerted in formalin without any fixation.

RESULTS

Right-sided tumors — 201 (57.4%), left-sided — 124 (35.4%), rectal — 25 (7.2%). Average size 5.3 mm (from 3 to 10 mm). Polypoid lesions (0-Is) — 112 (32%), non-polypoid (0-IIa, 0-IIa+IIc) — 238 (68%). 40 polyps (11.4%) were fragmented during extraction. 50 cases (14.3%) — hyperplastic polyps, 63 (18%) — serrated adenomas without dysplasia, 162 (46.3%) — LGD adenomas, 72 (20.6%) — DTC adenomas, intraepithelial cancers (m1, Tis) — 3 (0.8%). 217 cases of adenomas (72.3%) were resected R0, 12 cases (4%) — R1. Reasons of Rx: wrong orientation, p=0.0016; fragmentation of specimen during cutting up, p=0.0043. Right-sided and larger polyps fragmented more often, p<0.0001; 5.82 mm vs 5.2 mm, p=0.01. In fixed polyps were more serrated adenomas and less hyperplastic polyps (p=0.0003); more DTC, p=0.013.

CONCLUSION

Cold snare polypectomy is a safe and effective method. Fragmentation risk depends on size and localization. Fixation of the specimen with pins improve diagnostic of serrated adenomas and probably may cause DTC overdiagnosis.

Keywords:

cold snare polypectomy

colon

specimen

fixation

Authors:

Khalin K.D.

Clinical Hospital RZD-Medicine;
Pacific State Medical University

Ogurchyenok N.E.

Clinical Hospital RZD-Medicine

Agapov M.Y.

City Clinical Oncology Hospital

ORCID: 0000-0002-6322-6782

Zvereva L.V.

Clinical Hospital RZD-Medicine

Stegniy K.V.

Pacific State Medical University

Received:

12.06.2020

Accepted:

06.10.2020

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