Cold Snare Polypectomy Versus. Endoscopic Mucosal Resection

Study Overview
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Brief Summary
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The investigators will investigate the efficacy of EMR compared to CSP in treatment of small colon polp (6 10mm). One aim of this study was to investigate the necessity of EMR on resection of small colon polyp.

Detailed Description
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With sized polyp from 6mm to less than 10mm, it has been classified by the previous studies as a small polyp. Their potential for advanced neoplasia is usually size-dependent, but some recent studies found that, even in diminutive and small polyps, the rate of advanced neoplasia is relatively high about 9%-10%. The investigators will prospectively investigate postprocedural outcomes, such as retrieval rate, procedural time, overall complication rate (Intraprocedural bleeding, postprocedural bleeding, and perforation) in colonoscopic polypectomy of small polyp between CSP and EMR.

Official Title
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Comparison of Efficacy Between Cold Snare Polypectomy and Endoscopic Mucosal Resection in Treatment of Small Polyp

Conditions
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Colonic Polyp

Intervention / Treatment
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* Other: EMR
* Other: CSP


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All those over the age of 20 years who agree informed consent and who have at least one polyp of eligible size (6-10 mm) Exclusion Criteria: (1) patients taking anticoagulant therapy during the past 1 week of the procedure, (2) known coagulopathy, (3) history of liver cirrhosis, chronic kidney disease, malignancy, inflammatory bowel diseases or significant infectious disease, (4) American Society of Anesthesiology class III or more, and (5) pedunculated polyps and polyps with malignant feature.

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cold snare polypectomy<br>CSP will be performed by closing the snare loop after positioning the open snare at the point of lesion. | Other: CSP<br>* performing CSP for patients with small polyp<br>|
| Active Comparator: Endoscopic mucosal resection<br>EMR will be performed in the way of drawing the lesion into the loop of the snare and resecting followed by saline injection to the its margin. | Other: EMR<br>* performing EMR for patients with small polyp<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| complete resection rate (CRR) |  | Up to 2 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| incidence of complications (Intraprocedural bleeding, postprocedural bleeding, and perforation) |  | Up to 2 months | 
| necessity of hemostasis (due to Intraprocedural bleeding or postprocedural bleeding) |  | Up to 2 months | 
| Polyp retrieval rate |  | Up to 2 months | 
| hospitalization period |  | Up to 2 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Colonic polyp