What Is the Most Accurate Method for the Treatment of Diminutive Colonic Polyps?

Different methods such as standard, hot, and jumbo forceps are used in endoscopic treatment of diminutive colon polyps. In the current study, it was aimed to compare efficacy and safety of standard and jumbo forceps polypectomy methods in treatment of diminutive colon polyps of 5 mm. Polyps with 5 mm which were excised during colonoscopy by using standard or jumbo forceps were evaluated. Standard and jumbo forceps polypectomy methods were randomly performed in 212 consecutive patients with diminutive colorectal polyp. One-bite polypectomy and complete resection rates were also determined among polypectomy methods. Results of 161 standard forceps polypectomy and 102 jumbo forceps polypectomy were retrospectively evaluated. Both one-bite polypectomy and complete resection rates were significantly higher in the jumbo forceps polypectomy group than the standard forceps polypectomy group (P< 0.001). In the subgroup analysis performed according to polyp sizes, complete resection rate among polyps with 3-mm diameter was determined as 100%. However, numbers of bites in 4-mm and 5-mm polyps were higher in the standard forceps polypectomy group, and complete resection rate was lower than in the jumbo forceps polypectomy group (P< 0.001). Both endoscopic treatment methods may be employed in treatment of diminutive colon polyps with 5 mm. However, jumbo forceps polypectomy is a more effective treatment method in 4to 5-mm polyps with high one-bite polypectomy and complete resection rate. (Medicine 94(15):e621) Abbreviations: EMR = endoscopic mucosal resection, SFP = standard forceps polypectomy, JFP = jumbo forceps polypectomy, NBI = narrow band imaging. INTRODUCTION T he main objective of colonoscopy, which is used to decrease colon cancer risk, and as a golden standard screening i, MD, Emrah Alp Ekinci, MD, hmut Arabul, MD, and Belkis Unsal, MD endoscopically. According to their sizes and their endoscopic appearances, polyps may be removed by one of endoscopic treatment methods such as cold and hot forceps polypectomy, cold or hot snare polypectomy, endoscopic mucosal resection (EMR), and endoscopic submucosal dissection. Different methods such as standard, hot, and jumbo forceps polypectomy (JFP) may be used in treatment of colon polyp 5 mm, named as diminutive polyps. If a diminutive polyp is encountered during colonoscopy, selection of endoscopic method depends on experience and preference of the endoscopist. In a study performed among American gastroenterologists, 50.3% of participants preferred forceps polypectomy method in polyps with 1to 3-mm size, whereas 18.5% preferred cold forceps polypectomy in polyps with 4to 6-mm size. Although it is reported in recent years that Jumbo forceps, which is larger in size than standard forceps, is an effective treatment modality in small size colon polyps, there is still no consensus in endoscopic treatment of diminutive polyps. Moreover, there is no study comparing efficacies of SFP and JFP methods in patients with 3to 5-mm polyp sizes. Our aim in the current study was to investigate efficacy and safety of SFP and JFP methods in diminutive colon polyps.