Randomized Controlled Trial Finds Cold Forceps Are Equally Effective and Faster Than Cold Snare for Colorectal Polyps ≤3 mm
Douglas K. Rex, MD, MASGE, reviewing Wei MT, et al. Am J Gastroenterol 2022 Apr 25.
Previous studies have found that a cold snare is more effective than cold forceps for polypectomy of polyps ≥4 mm in size, but data are mixed regarding polyps ≤3 mm in size. In this study, 279 polyps ≤3 mm were randomized to cold snare polypectomy (CSP) versus cold forceps polypectomy (CFP).
A dedicated 9-mm cold snare was used for CSP, and large-capacity forceps were used for CFP. Complete resection was evaluated by 2 biopsy specimens taken from the margin of each fully resected polyp. All polypectomies were performed by one of 4 experienced endoscopists.
CFP was faster than CSP (23.2 vs 42.3 seconds; P<.001). Piecemeal removal of polyps was performed more often with CFP than CSP (15.6% vs 3.6%; P<.001). There were only 2 cases in each arm with positive margin biopsies, and complete resection rates were 98.3% in both groups.
COMMENTThese data suggest that, for polyps ≤3 mm in size, polypectomy using large-capacity cold forceps is equal to cold snare polypectomy in efficacy and is faster to perform. Based on available data, forceps should not be used for polyps ≥4 mm because they are less effective, likely due to the need for piecemeal resection.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Wei MT, Louie CY, Chen Y, et al. Randomized controlled Trial Investigating cold snare aNd forceps polypectomY among small POLYPs in rates of complete resection: the TINYPOLYP Trial. Am J Gastroenterol 2022 Apr 25. (Epub ahead of print) (https://doi.org/10.14309/ajg.0000000000001799)
