Clin Endosc.  2021 May;54(3):390-396. 10.5946/ce.2020.096.

Dedicated Cold Snare vs. Traditional Snare for Polypectomy of Diminutive and Small Lesions in a Porcine Model: A Research Group for Endoscopic Instruments and Stents (REIS) Study

• Lee HH
• Lee BI
• Kim JW
• Lim H
• Lee SH
• Cho JH
• Jung Y
• Kim KO
• Kim CG
• Lee KM
• Park JJ
• Choi MG
• Chun HJ
• Kim HG

• KMID: 2516319
• DOI: http://doi.org/10.5946/ce.2020.096

Abstract

Background/Aims
The aim of this in vivo animal study was to evaluate the effectiveness and safety of dedicated cold snare (DCS) compared with those of traditional snare (TS) for cold snare polypectomy (CSP).
Methods
A total of 36 diminutive (5 mm) and 36 small (9 mm) pseudolesions were made by electrocoagulation in the colons of mini-pigs.
Results
For the diminutive lesions, there were no significant differences in technical success rate, procedure time, or complete resection rate between the DCS and TS groups; the rate of uneven resection margin in the DCS group was significantly lower than that of the TS group. For small lesions, technical success rate and complete resection rate were significantly higher in the DCS group than in the TS group (100% [18/18] vs. 55.6% [10/18], p=0.003; 94.4% [17/18] vs. 40% [4/10], p=0.006). In addition, the procedure duration was significantly shorter, and the rate of uneven resection margin was significantly lower in the DCS group (28.5 sec vs. 66.0 sec, p=0.006; 11.1% [2/18] vs. 100% [10/10], p<0.001). Two cases of perforation occurred in the DCS group. Multivariate analysis revealed that DCS use was independently associated with complete resection.
Conclusions
DCS is superior to TS in terms of technical success, complete resection, and reducing the duration of the procedure for CSP of small polyps.

Keyword

Animal model; Cold snare polypectomy; Colonic polyps; Dedicated cold snare; Perforation

Figure

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  Fig. 1. Creating two sizes (5 mm and 9 mm) of pseudolesions by electrocoagulation using a snare tip.

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  Fig. 2. (A) Dedicated cold snare (Optimos Polypectomy Snare Cold Type; Taewoong, Gimpo, Korea). Left, 10 mm. Right, 15 mm. (B) Traditional snare (Optimos Polypectomy Snare Oval Type; Taewoong). Left, 10 mm. Right, 15 mm.

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  Fig. 3. Resection margins of cold snare polypectomy according to snare type and size. (A) Dedicated cold snare, 10 mm. (B) Dedicated cold snare, 15 mm. (C) Traditional snare, 10 mm. (D) Traditional snare, 15 mm.

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