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Academic Frontiers

APPLICATION PROGRESS OF POLYP SNARE IN COLORECTAL POLYPS

Ⅰ. Resection technique of polyp cold snare

Cold excision techniques should include biopsy forceps cold excision, cold excision of polyp cold snare, mucosal cold excision and so on. A small snare with a diameter of 1.5 cm should be selected.


Spherical diameter or surface diameter of polyp is less than 1.0cm. To complete the polyp snare, the straightening lens is inflated, the snare is tightened and slightly raised, and clip sutures are required. Polyps can be pedunculated, pedunculated or pedunculated. Polyps can be inflammatory or adenoma in nature.


Hospitalized patients should fast for more than 12 hours, and only eat if there is no perforation and bleeding, and be observed in hospital for more than 24 hours. Outpatients, equivalent to a large specimen of trap biopsy, are sent to the ward for nursing, without fasting, eating liquid food for 12 hours, and observing for 12 to 24 hours.


Ⅱ. Advantages of polyp cold snare resection


1. Convenience and fast healing.


2. Cold excision of suitable polyps is safe, and it is safe to expand when needed. According to literature reports, bleeding and perforation are not easy to occur.


3. Only the polyp snare can be used, eliminating the need for injection needles, electric knives, etc. The deep penetration of electrocution without injection, and the deep penetration of hot tweezers and other treatments.


4. Save costs.


5. The sessile is completely trapped. After the sessile injection, the EMR (EMRC) attracted by the non-transparent cap is not easy to be trapped.


6. It can also operate without an electric knife.


7. The polyp cold snare can be rotated, which is flexible and convenient to use.


8. Suitable for primary hospitals, it can be selected to case promotion.


9. The use of snare is often excision, but the treatment with biopsy forceps instrument is not clear.


10. The snare is more thorough than the biopsy forceps.


11. Those who take mannitol should not use electrosurgery. It is suitable for cold excision of polyps with cold snare. When appropriate, on-site treatment is convenient for patients.


12. A small snare with a diameter of 15mm can measure the size of the polyp, which is helpful for judging whether the polyp resection condition is sufficient.


Ⅲ. Precautions for polyp cold snare excision


1. Large polyps are limited.


2. Suitable for EMR and ESD endoscopy, mature and complete EMR or ESD removal technology can be selected.


3. The pedicle polyp can also be directly trapped for electric cutting, not fine and special cold cutting, and the inside of the pedicle is left, and the clip can hold the root.


4. The usual snare can also be used, and the special thin polyp snare is more suitable for cold cutting.


5. The cold excision in the literature is invalid, and the electric excision is not directly trapped, and finally changed to EMR.


6. Pay attention to complete excision.


The incidence and mortality of gastrointestinal cancers such as colorectal cancer remain high. The morbidity and mortality rates are among the top cancers, and timely inspections should be made if necessary.

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