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Local recurrence and its risk factors after cold snare polypectomy of colorectal polyps.
- Source :
-
Surgical endoscopy [Surg Endosc] 2020 Jul; Vol. 34 (7), pp. 2918-2925. Date of Electronic Publication: 2019 Sep 03. - Publication Year :
- 2020
-
Abstract
- Background: Local recurrence after cold snare polypectomy (CSP) of colorectal polyps has not been well analyzed. In this study, we analyzed the characteristics of local recurrence.<br />Methods: We retrospectively reviewed consecutive lesions resected by CSP from 2014 to 2016 and lesions that were followed up at ≥ 10 months after CSP, were analyzed. Our indication for CSP was a benign tumor of < 15 mm in size. We analyzed local recurrence and its risk factors using multivariate analyses. In addition, we compared lesions of ≥ 10 mm and < 10 mm. Moreover, therapeutic methods for recurrence were analyzed.<br />Results: Finally, we analyzed 554 cases out of 820 consecutive cases. The mean polyp size was 5.3 ± 2.8 mm and the en bloc resection and histopathological complete resection rates were 99.3% and 70.2%, respectively. The overall recurrence rate was 1.9% (mean follow-up period: 13.0 ± 4.0 months). Significant differences were observed between 11 recurrent lesions and 543 lesions without recurrence regarding polyp size (8.0 ± 3.7 mm vs. 5.2 ± 2.7 mm, p < 0.001), rate of sessile-serrated polyp (27.3% vs. 3.0%, p < 0.001), and histopathological positive margin (45.4% vs. 3.7%, p = 0.019). Multivariate analyses showed that a histopathological positive margin was the only significant risk factor for local recurrence (OR 16.600, 95% CI 3.707-74.331, p < 0.001). Regarding the comparison between 74 lesions of ≥ 10 mm and 480 lesions of < 10 mm, significant differences were observed in the en bloc resection rate (93.2% vs. 100%, p < 0.001), high-grade dysplasia rate (8.1% vs. 0.8%, p < 0.001), and histopathological complete resection rate (54.0% vs. 72.7%, p = 0.001). The recurrence rates of these two groups were 5.4% and 1.4%, respectively (p = 0.069). All recurrent cases could be resected with repeat CSP.<br />Conclusions: The local recurrence rate after CSP for lesions of < 10 mm was 1.4%. CSP was not recommended for lesions of ≥ 10 mm due to high rates of recurrence and malignancy.
- Subjects :
- Colonic Polyps pathology
Colonic Polyps surgery
Colonoscopy adverse effects
Colorectal Neoplasms pathology
Colorectal Neoplasms surgery
Humans
Intestinal Polyps pathology
Margins of Excision
Microsurgery
Postoperative Hemorrhage etiology
Recurrence
Retrospective Studies
Risk Factors
Colonoscopy methods
Intestinal Polyps surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2218
- Volume :
- 34
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Surgical endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 31482353
- Full Text :
- https://doi.org/10.1007/s00464-019-07072-7