Clinical Efficacy And Safety Analysis Of Cold Resection In The Treatment Of Small Colorectal Polyps

Background:Colorectal cancer remains a major challenge in the medical field today.About 60-80% of colorectal cancers are caused by intestinal polyps,and removing them has been shown to reduce the incidence of colorectal cancer.90% of polyps detected on colonoscopy were small polyps(≤5 mm)or small polyps(6～10 mm),Over the past decade,EMR has been the most commonly used thermal snare polypectomy to effectively and completely remove polyps,thereby reducing the risk of death associated with colorectal cancer.However,cold ablation technique has been applied more and more in recent years due to its lack of electric cautery effect and simple operation.Objective: In this study,we compared the complete resection rates and complications during Cold snare polyectomy(CSP)and Endoscopic submucosal resection(EMR).Objective To investigate the clinical efficacy and safety of cold snare polypectomy(CSP)in the treatment of colorectal polyps(4-10 mm diameter).Methods: A total of 315 patients with 4-10 mm diameter single colorectal polyp who underwent endoscopic treatment in our hospital from June 2021 to October 2022 were selected and divided into CSP group(n = 158)and EMR group(n = 157).The complete resection rate of polyps under endoscopy and histology,operation time,incidence of bleeding and perforation,and the number of titanium clips used were compared between the two groups.Results: Among the 315 patients included in the study,there were no significant differences between the CSP group and the EMR group in gender,age,polyp size,location,shape,Paris typing,PP typing,and histopathological type(P<0.05).In terms of complete resection rate,there was no statistical difference between endoscopic complete resection rate and histological complete resection rate.In terms of operation time,CSP group and EMR group(210.58s±114.58 s vs 466.99s±260.51s)took less time than EMR group.Compared with EMR group(1.97±0.944 vs 3.29±1.27),CSP group used fewer metal clips on wound surface.The rates of immediate intraoperative bleeding were CSP(4.43%)and EMR(1.27%),and the rates of delayed postoperative bleeding were CSP(0%)and EMR(3.82%),respectively,and the differences were statistically significant(P< 0.05),all the 6 patients with postoperative bleeding were in EMR group,and none in CSP group.No intraoperative or postoperative perforation occurred in both groups.Conclusion: In the resection of colorectal(micro)small polyps(4-10 mm in diameter),CSP has a complete resection rate that is no less than EMR.Compared with EMR,CSP has a lower incidence of postoperative delayed bleeding,and has better clinical efficacy and safety.Besides,the operation time is short,the consumables are used less,and the medical resources and costs can be saved.