PT  - JOURNAL ARTICLE
AU  - Takuji Kawamura
AU  - Yoji Takeuchi
AU  - Satoshi Asai
AU  - Isao Yokota
AU  - Eisuke Akamine
AU  - Minoru Kato
AU  - Takuji Akamatsu
AU  - Kazuhiro Tada
AU  - Yoriaki Komeda
AU  - Mineo Iwatate
AU  - Ken Kawakami
AU  - Michiko Nishikawa
AU  - Daisuke Watanabe
AU  - Atsushi Yamauchi
AU  - Norimasa Fukata
AU  - Masaaki Shimatani
AU  - Makoto Ooi
AU  - Koichi Fujita
AU  - Yasushi Sano
AU  - Hiroshi Kashida
AU  - Satoru Hirose
AU  - Hiroyoshi Iwagami
AU  - Noriya Uedo
AU  - Satoshi Teramukai
AU  - Kiyohito Tanaka
TI  - A comparison of the resection rate for cold and hot snare polypectomy for 4–9 mm colorectal polyps: a multicentre randomised controlled trial (CRESCENT study)
AID  - 10.1136/gutjnl-2017-314215
DP  - 2017 Sep 28
TA  - Gut
PG  - gutjnl-2017-314215
4099  - http://gut.bmj.com/content/early/2017/09/28/gutjnl-2017-314215.short
4100  - http://gut.bmj.com/content/early/2017/09/28/gutjnl-2017-314215.full
AB  - Objective To investigate the success rate of cold snare polypectomy (CSP) for complete resection of 4–9 mm colorectal adenomatous polyps compared with that of hot snare polypectomy (HSP).Design A prospective, multicentre, randomised controlled, parallel, non-inferiority trial conducted in 12 Japanese endoscopy units. Endoscopically diagnosed sessile adenomatous polyps, 4–9 mm in size, were randomly assigned to the CSP or HSP group. After complete removal of the polyp using the allocated technique, biopsy specimens from the resection margin after polypectomy were obtained. The primary endpoint was the complete resection rate, defined as no evidence of adenomatous tissue in the biopsied specimens, among all pathologically confirmed adenomatous polyps.Results A total of 796 eligible polyps were detected in 538 of 912 patients screened for eligibility between September 2015 and August 2016. The complete resection rate for CSP was 98.2% compared with 97.4% for HSP. The non-inferiority of CSP for complete resection compared with HSP was confirmed by the +0.8% (90% CI −1.0 to 2.7) complete resection rate (non-inferiority p<0.0001). Postoperative bleeding requiring endoscopic haemostasis occurred only in the HSP group (0.5%, 2 of 402 polyps).Conclusions The complete resection rate for CSP is not inferior to that for HSP. CSP can be one of the standard techniques for 4–9 mm colorectal polyps. (Study registration: UMIN000018328)