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

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 ofmini-pigs. Results: For the diminutive lesions, there were no significant differences in technical success rate, procedure time, or completeresection rate between the DCS and TS groups; the rate of uneven resection margin in the DCS group was significantly lower thanthat of the TS group. For small lesions, technical success rate and complete resection rate were significantly higher in the DCS groupthan 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 procedureduration was significantly shorter, and the rate of uneven resection margin was significantly lower in the DCS group (28.5 sec vs. 66.0sec, p=0.006; 11.1% [2/18] vs. 100% [10/10], p<0.001). Two cases of perforation occurred in the DCS group. Multivariate analysisrevealed 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 forCSP of small polyps.