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Background: : Patients with end-stage renal disease (ESRD) have a higher incidence of clinically relevant complications, such as bleeding and perforation after polyp resection, compared to patients without underlying diseases. Cold snare polypectomy (CSP) is increasingly used for the removal of small polyps and diminutive polyps due to its shorter procedure time and low risk of bleeding and perforation. However, there have been few studies on the effectiveness and safety of CSP in patients with ESRD. The aim of this study was to compare the efficacy and safety of CSP and endoscopic mucosal resection (EMR) in ESRD patients.
Methods: : This study was a retrospective study. We performed propensity score-matched analysis in patients with ESRD who underwent endoscopic resection for 3-10-mm-sized colorectal polyps at Seoul St. Mary's Hospital, from January 2014 to December 2019.
Results: : After 1:1 ratio matching, 406 polyps were included: 203 polyps were resected with CSP and 203 polyps with EMR. There was no difference between the CSP group and EMR group in incomplete resection rate (4.43% vs. 1.97%, P = 0.16). There were no differences between the CSP and EMR group for immediate bleeding (5.42% vs. 7.88%, P = 0.32) and delayed bleeding (0% vs. 0.49%, P = 1.00). No perforation occurred in either group.
Conclusions: : There were no differences between the CSP and EMR group in terms of efficacy and safety. CSP can be one of the standard methods for the removal of 3-10-mm-sized colorectal polyps in patients with ESRD.
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http://dx.doi.org/10.4103/sjg.sjg_371_21 | DOI Listing |
Lancet Gastroenterol Hepatol
October 2025
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.
Background: Guidelines recommend leaving in situ rectosigmoid polyps diagnosed during colonoscopy that are 5 mm or smaller if the endoscopist optically predicts them to be non-neoplastic. However, no randomised controlled trial has been done to examine the efficacy and safety of this strategy.
Methods: This open-label, multicentre, non-inferiority, randomised controlled trial enrolled adults age 18 years or older undergoing colonoscopy for screening, surveillance, or clinical indications across four Italian centres.
Gastrointest Endosc
September 2025
Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Medicine, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH; NH Colonoscopy Registry, Lebanon, NH.
Background And Aims: Data comparing the location of polyp yield in patients with positive stool tests can aid screening test selection. We conducted a cross sectional analysis of New Hampshire Colonoscopy Registry data to compare the location, left versus right side of the colon, of neoplasia detected on colonoscopy following a mt-sDNA+ or FIT+ test as compared to a reference group having colonoscopy without a stool test.
Methods: Our outcomes were advanced lesions (adenoma and/or serrated polyp, including cancer), advanced adenomas (AA), or advanced serrated polyps (ASP), stratified by location.
Fam Cancer
September 2025
Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Avenue / A30, Cleveland, OH, 44195, USA.
Familial adenomatous polyposis (FAP) is an inherited condition that predisposes individuals to colorectal cancer without preventive treatment. Surgical management typically involves restorative proctocolectomy with an ileal pouch anal anastomosis or colectomy with ileorectal anastomosis. Complete removal of the large intestine and rectum with a permanent stoma may also be required in selected cases.
View Article and Find Full Text PDFFam Cancer
September 2025
Ambry Genetics, 1 Enterprise, Aliso Viejo, CA, 92656, USA.
Pathogenic variants in the APC gene are classically associated with autosomal dominant familial adenomatous polyposis (FAP), characterized by tens-to-thousands of colonic adenomatous polyps and a high-penetrance predisposition to colorectal cancer. More recently, specific PVs in the YY1 binding motif of APC promoter 1B have been associated with autosomal dominant gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS), characterized by tens-to-thousands of fundic gland polyps and a predisposition to gastric cancer but which are only rarely associated with features consistent with FAP. Although management guidelines currently treat FAP and GAPPS as mutually exclusive conditions, the extent of phenotypic overlap is not well-characterized.
View Article and Find Full Text PDFIET Syst Biol
September 2025
School of Computer and Information Techonology, Xinyang Normal University, Xinyang, China.
Accurate polyp segmentation is crucial for computer-aided diagnosis and early detection of colorectal cancer. Whereas feature pyramid network (FPN) and its variants are widely used in polyp segmentation, inherent limitations existing in FPN include: (1) repeated upsampling degrades fine details, reducing small polyp segmentation accuracy and (2) naive feature fusion (e.g.
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