A Randomized Controlled Study Of Endoscopic Mechanical Resection Versus High-frequency Electric Resection Of Small Colorectal Polyps

Objective: to compare the efficacy and safety of endoscopic mechanical resection and high-frequency electric resection for small colorectal polyps,further to explore a safe and effective endoscopic resection for small colorectal polyps.Methods: 120 patients who detected small colorectal polyps(less thanor equal to 10 mm)by colonoscopy in the outpatient department of the fourth hospital of Hebei Medical University from January 2019 to December 2019 were divided into two groups randomly: mechanical resection group(less than or equal to 5 mm polyps were treated with cold forceps,6-10 mm polyps were treated with cold snares)and high-frequency electric resection group(less than or equal to 5 mm polyps were treated with hot forceps,6-10 mm polyps were treated with hot snares),60 cases in each group.Endoscopic evaluation of polyps nature by NICE classification,except canceration.An additional forceps biopsies were performed at the margins of polypectomy sites to assess the complete resection after polypectomy.In some cases,the wound was closed by titanium clip.After one month colonoscopy was reviewed to observe the retention of titanium clips and evaluate the thoroughness of polypectomy.The rate of complete polyp resection,the incidence of postoperative complications(hemorrhage,perforation),operation time and treatment cost were compared between the two groups to explore the effectiveness,safety,simplicity and economy of the two methods.Results: For polyps ?5mm,the complete removal rate of polyps in cold and hot forceps groups was 93% vs 92.3%,with no significant difference between the two groups(P>0.05).There was no delayed bleeding or perforation in both groups,and intraoperative bleeding was 4.7% vs 2.6%(P>0.05).The procedure time was 2.14±0.87 min vs 3.02±0.66 m in(P<0.05).In terms of treatment cost,the former was less,160 yuan vs 1000 yuan,(P<0.05).For 6-10 mm polyps,the total polyp resection rate was not significant difference(92.5% vs 97.6%,P=0.282)between the cold snares polypectomy group and the hot snares polypectomy group;There was no delayed bleeding or perforation in the two groups,and the intraoperative bleeding was 7.5% vs 0%(P>0.05).Time spent: the former took less time,3.15±0.66 min vs5.47±0.11min(P<0.05);Treatme nt costs: the former cost less($500 & $1000).After one month,the retention rate of titanium clips was 62.5%(15/24).The sensitivity,specificit y and accuracy of NICE classification for evaluating polyp Pathological nature were 94.2%,90.7% and 93.3%,respectively.Conclusions:1.Both mechanical resection and high-frequency electric resection can effectively treat small colorectal polyps,but the former is simpler,faster,more economical and safer.2.NICE classification can accurately judge the nature of small colon polyps and effectively guide the selection of polypectomy.3.The titanium clip marker can be used to track the prognosis and recurrence of polyps in a short time,and it has the function of treating and preventing bleeding and perforation.