ASGE Postgraduate Course at ACG 2022: Expanding the Scope of Fundamental and Advanced Endoscopy (On-Demand) | October 2022-Point Counterpoint: Selecting Polypectomy Technique Based on Polyp Characteristics

Point Counterpoint: Selecting Polypectomy Technique Based on Polyp Characteristics

Video Transcription

Video Summary

In this video, Dr. Amit Rastogi from the University of Kansas discusses the limitations of cold-snare polypectomy and argues that it is not an ideal method for certain polyps with advanced histology. He explains that the aim of a good polypectomy is to remove the entire polyp completely and safely, allowing for accurate histological interpretation. However, cold-snare polypectomy lacks cautery and heat, limiting the amount of tissue that can be cut and resulting in a superficial resection plane. The snare size used for cold-snare polypectomy also limits the size of polyps that can be removed. Dr. Rastogi presents data showing that cold-snare polypectomy is less effective in achieving complete histological remission compared to other techniques such as hot-snare, EMR, or ESD. He highlights the importance of proper lesion selection and recommends alternative methods, such as hot-snare polypectomy or EMR, for polyps with advanced histology or larger size. Dr. Rastogi also emphasizes the need for endoscopists to be familiar with classification systems like Paris, NICE, and JNET to help determine the appropriate method for polypectomy. He concludes by providing case examples and guidelines for selecting the appropriate technique based on polyp characteristics. No credits are granted.

Asset Subtitle

Amit Rastogi, MD, FASGE

Keywords

cold-snare polypectomy

limitations

advanced histology

polyp removal

histological interpretation