Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial
- Author:
Ramona SCHIUMERINI
1
;
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 Information
- Publication Type:Original Article
- From:Clinical Endoscopy 2025;58(2):291-302
- CountryRepublic of Korea
- Language:English
-
Abstract:
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”.
