Recurrence rate and lesions characteristics after cold snare polypectomy of high-grade dysplasia and T1 lesions: A multicenter analysis

Yoshida N 1 , Fukumoto K 2 , Hasegawa D 3 , Inagaki Y 4 , Inoue K 1 , Hirose R 1 Show all authors , Dohi O 1 , Ogiso K 5 , Murakami T 6 , Tomie A 7 , Okuda K 8 , Inada Y 9 , Okuda T 9 , Rani RA 10 , Morinaga Y 11 , Kishimoto M 11 , Itoh Y 1

Affiliations 

  • 1 Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
  • 2 Department of Gastroenterology, Nara City Hospital, Nara, Japan
  • 3 Department of Gastroenterology, Ayabe City Hospital, Kyoto, Japan
  • 4 Department of Gastroenterology, Nishijin Hospital, Kyoto, Japan
  • 5 Department of Gastroenterology, Osaka General Hospital of West Japan Railway Company, Osaka, Japan
  • 6 Department of Gastroenterology, Japan Community Health Care Organization, Kyoto Kuramaguchi Medical Center, Kyoto, Japan
  • 7 Department of Gastroenterology, Saiseikai Kyoto Hospital, Kyoto, Japan
  • 8 Department of Gastroenterology, Kyoto Kujo Hospital, Kyoto, Japan
  • 9 Department of Gastroenterology, Fukuchiyama City Hospital, Kyoto, Japan
  • 10 Gastroenterology Unit, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
  • 11 Department of Surgical Pathology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
J Gastroenterol Hepatol, 2021 Dec;36(12):3337-3344.
PMID: 34260116 DOI: 10.1111/jgh.15625

Abstract

BACKGROUND AND AIM: High-grade dysplasia (HGD) and T1 lesions are accidentally resected by cold snare polypectomy (CSP) and the characteristics, and follow-up of them has not been reported. In this study, we analyzed the histopathological findings and recurrence of them.

METHODS: This was a multicenter retrospective-cohort study. We collected HGD and T1 lesions of ≤ 10 mm resected by CSP among 15 520 patients receiving CSP from 2014 to 2019 at nine related institutions, and we extracted only cases receiving definite follow-up colonoscopy after CSP of HGD and T1 lesions. We analyzed these tumor's characteristics and therapeutic results such as R0 resection and local recurrence and risk factors of recurrence.

RESULTS: We collected 103 patients (0.63%) and extracted 80 lesions in 74 patients receiving follow-up colonoscopy for CSP scar. Mean age was 68.4 ± 12.0, and male rate was 68.9% (51/80). The mean tumor size (mm) was 6.6 ± 2.5, and the rate of polypoid morphology and rectum location was 77.5% and 25.0%. The rate of magnified observation was 53.8%. The rates of en bloc resection and R0 resection were 92.5% and 37.5%. The local recurrence rate was 6.3% (5/80, median follow-up period: 24.0 months). The recurrence developed within 3 months after CSP for four out of five recurrent cases. Comparing five recurrent lesions to 75 non-recurrent lesions, a positive horizontal margin was a significant risk factor (60.0% vs 10.7%, P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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