| 特集名 | Cold polypectomyの是非を問う | |
|---|---|---|
| 題名 | 〔Review〕国際的にみるCold polypectomyの歴史と現状 | |
| 発刊年月 | 2016年 09月 | |
| 著者 | 佐野 亙 | 佐野病院消化器センター |
| 著者 | 佐野 寧 | 佐野病院消化器センター |
| 【 要旨 】 | 従来の通電してポリープを切除するHot polypectomyに対し，通電せずにポリープを切除するCold polypectomyが近年，日本でも注目されている． 海外でのCold polypectomyの歴史は古く，初めて報告されたのは今から20年以上前のことである．その後，国内外でその安全性，根治性に関する検討が多数行われ，大腸ポリープの大部分を占める10mm未満のポリープに対しては，安全性はHot polypectomyより高く，根治性はほぼ同等と考えられている．Cold polypectomyは，今後日本でも普及していくものと思われる． |
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| Theme | Cold polypectomy : Merits and demerits | |
|---|---|---|
| Title | Review on cold polypectomy techniques for small and diminutive colorectal polyps | |
| Author | Wataru Sano | Gastrointestinal Center, Sano Hospital |
| Author | Yasushi Sano | Gastrointestinal Center, Sano Hospital |
| [ Summary ] | Approximately 90 % of colorectal polyps encountered during colonoscopy are <10 mm, 90 % of which are diminutive (≤5 mm). Although the risk of advanced neoplasia in diminutive polyps is extremely low, the safe and effective resection of these lesions is crucial to reduce the incidence and mortality of colorectal cancers. Many randomized controlled studies comparing cold biopsy forceps or snare polypectomy without cautery and hot biopsy forceps or snare polypectomy with cautery for small (6-9 mm) and diminutive polyps have been conducted to evaluate their safety and efficacy. These investigations have indicated that cold polypectomy is safer than hot polypectomy, with an almost equal efficacy. Therefore, cold polypectomy techniques have recently been preferred over hot polypectomy in Western countries. Over the last decade, hot biopsy forceps polypectomy has been gradually abandoned because of its increased risk of diathermic injury. In terms of complete resection, cold biopsy forceps and snare polypectomies are two possible alternatives for polyps ≤3 mm, whereas cold snare polypectomy should be used for larger lesions. Cold polypectomy techniques are now attracting increasing attention in Japan as well. In the next decade, cold polypectomy may play a central role in the resection of colorectal polyps <10 mm. |
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