This study will evaluate the efficacy and safety of cold snare polypectomy(CSP) and hot snare polypectomy(HSP) in the treatment of colorectal 4-9mm 0-Isp and 0-Ip polyps, and compare the complete resection rate, postoperative late bleeding rate, intraoperative bleeding rate, en bloc resection rate, operation time and the number of metal clips used. The conclusion of this study will help clinical doctor develop more effective resection strategies for colorectal 0-Isp and 0-Ip polyps, and provide more effective treatment for patients.
Age: 18-80 years old, male or female
At least one polyp with size of 4-9 mm 0-Isp or 0-Ip is found during colonoscopy
Voluntarily sign informed consent for endoscopic treatment
Boston Bowel Preparation Scale<6 points.
Patients who receive antiplatelet/anticoagulant therapy within 5 days before polypectomy.
Participants with a contraindication to colonoscopy and polypectomy.
Patients with inflammatory bowel disease or gastrointestinal polyposis.
Parallel
cold snare polypectomy
Procedure/SurgeryPlace the special cold snare in the normal mucosa 1-2mm away from the polyp edge. Tighten the snare at a constant speed and gently lift it up and then excision.
hot snare polypectomy
Procedure/SurgeryAccording to evaluation of the polyps, directly place the snare on the edge of the polyp including a clear margin of normal tissue (1-2 mm) or after submucosal injection. Tighten the snare at a constant speed and gently lift it up.Use the electrocoagulation and electroscission mode, power on for several seconds until the polyp is cut off.
Complete resection rate
The polyps and the two biopsies from the margin will be sent to the pathologist for further analysis. Two independent experienced pathologists will evaluate the samples separately and both are blinded to the technique performed for polypectomy. Complete resection rate is defined as the negative pathological evaluation of two biopsies obtained from the margin.
Postoperative delayed bleeding rate
Incidence of bleeding requiring endoscopic hemostasis intervention within 14 days after surgery
Intraoperative bleeding rate
Immediate bleeding is defined as bleeding persists \>60s after polypectomy according to the ESGE recommendations (2017) and requires for endoscopic intervention.
En bloc resection rate
The lesion is removed at one time, and the integrity of the specimen is maintained
Operation time
CSP: the time from the time the snare exits the working channel to leaving the wound. Hsp: time from the injection needle leaving the working channel to leaving the wound
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Ruijin Hospital
Lead sponsor
Jinshan Hospital Fudan University
Collaborator
Second Affiliated Hospital of Soochow University
Collaborator
The Third People's Hospital of Yunnan Province
Collaborator
People's Hospital Mojiang
Collaborator
Shanghai Yueyang Integrated Medicine Hospital
Collaborator
Huadong Hospital
Collaborator
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