Study On The Effectiveness And Safety Of Cold Resection Of 10-15mm Colorectal Polyps

Background :Colorectal cancer(CRC)is a malignant tumor derived from human colorectal mucosa epithelium.It is one of the highest incidence malignant tumors in the world at present,and its incidence rate and mortality rate are the third and second of all malignant tumors respectively.Resection of adenomatous polyps under colonoscopy can prevent them from developing into colorectal cancer.Therefore,screening and resecting polyps under colonoscopy can reduce the incidence rate of colorectal cancer.Cold snare polypectomy(CSP)has been widely used in the diagnosis and treatment of small colorectal polyps.However,the effectiveness and safety of CSP for the treatment of 10～15mm colorectal polyps have not been clearly defined,and the long-term recurrence rate has not been determined.Purpose:Compare the differences in complete resection rate and adverse event incidence between Cold snare polypectomy(CSP)and Hot snare polypectomy(HSP)in the treatment of 10～15mm colorectal polyps,and evaluate the effectiveness and safety of CSP in the treatment of 10～15mm colorectal polyps.Method:From June 2022 to February 2023,patients with colorectal polyps with a maximum diameter of 10-15 mm in the Laoshan Hospital area of Qingdao University Affiliated Hospital and planning to undergo polypectomy were randomly assigned to the CSP or HSP group.The differences in complete resection rate,whole block resection rate,intraoperative bleeding,delayed bleeding,intraoperative perforation,delayed perforation,and postoperative reactive colonic serositis between the two groups were compared.Results:The complete resection rate of colorectal polyps was 98.4% in the HSP group,and96.8% in the whole block resection rate;The complete resection rate in the CSP group was 97.3%,and the total resection rate was 98.7%.Compared with the HSP group,there was no significant difference(P>0.05).Intraoperative bleeding and delayed bleeding:Two cases(2.63%)in the CSP group and one case(1.61%)in the HSP group experienced intraoperative bleeding(P=0.167),and all cases were successfully treated with titanium clips for hemostasis.Two patients(3.22%)in the HSP group experienced delayed postoperative bleeding,while there was no delayed bleeding in the CSP group(0.0%).There was no statistically significant difference between the two groups(P=0.389).There was no intraoperative perforation or delayed perforation in both the CSP and HSP groups.Usage of titanium clips: 71(93.4%)patients in the CSP group used a total of 82 titanium clips,while 61(98.3%)patients in the HSP group used a total of 72 titanium clips.The usage rate of titanium clips in the CSP group was slightly higher than that in the HSP group,but the difference between the two groups was not statistically significant(P>0.05).Postoperative reactive colitis: The incidence of reactive colitis in the HSP group(4 cases,6.45%)was higher than that in the CSP group(0 cases,0.0%),but the difference was not statistically significant(P=0.082).Conclusion:CSP has a similar complete resection rate and overall resection rate for 10-15 mm colorectal polyps compared to HSP,but its overall incidence of adverse events is lower than HSP.From this,it can be seen that CSP is safe and effective for the removal of10-15 mm colorectal polyps,and is recommended for clinical application.