Risk factors associated with adenoma recurrence following cold snare endoscopic mucosal resection of polyps ≥ 20 mm: a retrospective chart review

Authors

Suraj Suresh, Henry Ford HealthFollow
Jinyu Zhang, Henry Ford HealthFollow
Abdelwahab Ahmed
Mouhanna Abu Ghanimeh, Henry Ford HealthFollow
Ahmed Elbanna, Henry Ford HealthFollow
Randeep Kaur, Henry Ford HealthFollow
Mahmoud Isseh
Andrew Watson, Henry Ford HealthFollow
Duyen T. Dang, Henry Ford HealthFollow
Krishnavel V. Chathadi, Henry Ford Health
Robert Pompa, Henry Ford HealthFollow
Sumit Singla, Henry Ford HealthFollow
Cyrus Piraka, Henry Ford HealthFollow
Tobias Zuchelli, Henry Ford HealthFollow

Recommended Citation

Suresh S, Zhang J, Ahmed A, Abu Ghanimeh M, Elbanna A, Kaur R, Isseh M, Watson A, Dang DT, Chathadi KV, Pompa R, Singla S, Piraka C, and Zuchelli T. Risk factors associated with adenoma recurrence following cold snare endoscopic mucosal resection of polyps ≥ 20 mm: a retrospective chart review. Endosc Int Open 2021; 9(6):E867-e873.

Document Type

Article

Publication Date

6-1-2021

Publication Title

Endosc Int Open

Abstract

Background and study aims: Cold snare endoscopic mucosal resection (EMR) is being increasingly utilized for non-pedunculated polyps ≥ 20 mm due to adverse events associated with use of cautery. Larger studies evaluating adenoma recurrence rate (ARR) and risk factors for recurrence following cold snare EMR of large polyps are lacking. The aim of this study was to define ARR for polyps ≥ 20 mm removed by cold snare EMR and to identify risk factors for recurrence.

Patients and methods: A retrospective chart review of colon cold snare EMR procedures performed between January 2015 and July 2019 at a tertiary care medical center was performed. During this period, 310 non-pedunculated polyps ≥ 20 mm were excised using cold snare EMR with follow-up surveillance colonoscopy. Patient demographic data as well as polyp characteristics at the time of index and surveillance colonoscopy were collected and analyzed.

Results: A total of 108 of 310 polyps (34.8 %) demonstrated adenoma recurrence at follow-up colonoscopy. Patients with a higher ARR were older ( P  = 0.008), had endoscopic clips placed at index procedure ( P  = 0.017), and were more likely to be Asian and African American ( P  = 0.02). ARR was higher in larger polyps ( P  < 0.001), tubulovillous adenomas ( P  < 0.001), and polyps with high-grade dysplasia ( P  = 0.003).

Conclusions: Although cold snare EMR remains a feasible alternative to hot snare polypectomy for resection of non-pedunculated polyps ≥ 20 mm, endoscopists must also carefully consider factors associated with increased ARR when utilizing this technique.

PubMed ID

34079869

Volume

9

Issue

6

First Page

867

Last Page

867