Endoscopic Resection Effective for SSPs ≥10 mm in Meta-analysis; Cold EMR May Be Best
Douglas K. Rex, MD, FASGE reviewing Chandrasekar VT, et al. Clin Gastroenterol Hepatol 2019 Nov 28.
This systematic review and meta-analysis identified 911 patients with 1137 sessile serrated polyps (SSPs) ≥10 mm in 14 studies, in which resection was performed by hot EMR in 8 studies, hot EMR and a second technique in 2, cold EMR in 2, and standard snare resection in 1. Overall, technical success was 99.5%, with a rate of residual polyp at follow-up of 4.3%, which was related to lesion size: 5.9% for lesions ≥20 mm and 1.2% for 10- to 19-mm lesions. The perforation rate was 0.3%, and the overall delayed hemorrhage rate was 1.3%, but there were no delayed hemorrhages with cold EMR. Residual polyp rates were numerically lower with cold EMR.
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Douglas K. Rex, MD, FASGE
Chandrasekar VT, Aziz M, Patel HK, et al. Efficacy and safety of endoscopic resection of sessile serrated polyps 10 mm or larger: a systematic review and meta-analysis: resection of sessile serrated polyps ≥10 mm. Clin Gastroenterol Hepatol 2019 Nov 28. (Epub ahead of print) (https://doi.org/10.1016/j.cgh.2019.11.041)