Jung YS, et al. – A systematic review and network meta–analysis was performed to compare the efficacy of cold polypectomy techniques for diminutive colorectal polyps. Observations suggested dedicated cold snare polypectomy (CSP) as superior to other cold polypectomy techniques in terms of complete histological eradication. For the removal of diminutive colorectal polyps, cold polypectomy using a dedicated snare could be recommended.

Methods

• All relevant randomized controlled trials published up until October 2016 examining the efficacy of cold polypectomy techniques for diminutive polyps were searched.
• Authors classified cold polypectomy techniques as cold forceps polypectomy (CFP), jumbo forceps polypectomy (JFP), traditional cold snare polypectomy (CSP), and dedicated CSP, according to the type of device.
• They performed a network meta-analysis to calculate the direct and indirect estimates of efficacy among the cold polypectomy techniques.

Results

• This meta-analysis included 7 studies with 703 patients and 968 polyps.
• Regarding comparative efficacy for complete histological eradication, no inconsistency was evident in the network (Cochran’s Q test, df = 4, P = 0.22; I2 = 30%).
• In terms of complete histological eradication, both dedicated and traditional CSP were superior to CFP (odds ratio [OR] [95% confidence interval [CI]] 4.31 [1.92–9.66] and 2.45 [1.30–4.63], respectively); dedicated CSP seemed superior to traditional CSP (OR [95% CI] 1.76 [1.07–2.89]); and no difference between JFP and CFP (OR [95% CI] 1.36 [0.40–4.61]) was observed.
• In terms of tissue retrieval rate, dedicated and traditional CSP appeared similar(OR [95% CI] 1.03 [0.44–2.38]).
• CSP and CFP appeared similar in terms of procedure time.