STUDY ON THE CLINICAL VALIDITY OF “COLD BIOPSY” TREATMENT FOR SMALL COLONIC POLYPS

Abstract

In Japan, “cold biopsy” (forceps resection) for small polypoid lesions is performed at the time of colonoscopic examination. However the treatment by cold biopsy remains controversial because of remnants and recurrence of the neoplastic polyp. In order to evaluate this problem, the records of 7779 cases of colonoscopy in our hospital were analyzed. The curative effect of treatment for polyps was examined separately among the different procedures of polyp excision: cold biopsy, snare polypectomy and hot biopsy. The curative effect of each procedure was judged endoscopically by the rediscovery of a polyp in the same colorectal portion where the polyp was excised in the former colonoscopy. The rediscovery rate of polyp was compared separately among 341 cases of cold biopsy, 566 cases of snare polypectomy and 85 cases of hot biopsy. As a result the curative effect of cold biopsy was almost equivalent to that of snare polypectomy and hot biopsy. However, it is necessary to select the strict adaptation of cold biopsy because larger polyps exceeding 3mm in diameter cannot always be completely removed with this procedure. Cold biopsy is a clinically useful procedure to treat small neoplastic polyps of a diameter of 3mm or less if performed under strict adaptation and extreme caution.