Clinical efficacy of mechanical resection versus high-frequency electrical resection of 6-15 mm sessile colorectal polyps

doi:10.3969/j.issn.1004-583X.2025.10.007

Abstract

Abstract:

Objective To compare the clinical effects of mechanical resection and high-frequency electrocautery resection in patients with 6-15 mm sessile colorectal polyps. Methods A total of 120 patients with 6-15 mm sessile colorectal polyps treated at our hospital from January 2023 to December 2024 were randomly assigned (random number table) to either a mechanical resection group using the cold snare technique or a high-frequency electrocautery resection group using the hot snare technique (n=60 each). Surgical outcomes, perioperative recovery metrics, serum gastrointestinal function markers, and complication rates were compared between groups. Results The mechanical resection group achieved a significantly higher cecal intubation rate and a significantly lower proportion of cumulative submucosal injury than the high-frequency electrocautery group (both P<0.05). The proportions of polyp recovery and polyp en bloc resection, and the total resection rate were comparable between the two groups ( all P>0.05).Operative time, time to first postoperative flatus, length of hospital stay, time to first postoperative bowel movement, and intraoperative blood loss were significantly lower in the mechanical resection group (all P<0.05). There was no significant difference in preoperative gastrointestinal function between groups (P>0.05). At postoperative day 3, serum levels of intestinal fatty acid-binding protein (I-FABP), vasoactive intestinal peptide (VIP), and diamine oxidase (DAO) were significantly lower in the mechanical resection group than in the high-frequency electrocautery group (all P<0.05). The overall incidence of complications was significantly lower with mechanical resection (P<0.05). Conclusion Both mechanical resection (cold snare) and high-frequency electrocautery resection (hot snare) provide effective treatment for 6-15 mm sessile colorectal polyps. However, mechanical resection demonstrates overall superiority in procedural performance, tissue safety, recovery, and complication profile, and may be recommended as the first-line technique for this population.

Key words: rectal polyp, mechanical cold snare polypectomy, high-frequency electrosurgical hot snare polypectomy, clinical effects

CLC Number:

R574

Liu Dongya, Sun Zhenglu, Du Yingying, Han Dazheng. Clinical efficacy of mechanical resection versus high-frequency electrical resection of 6-15 mm sessile colorectal polyps[J]. Clinical Focus, 2025, 40(10): 918-922.

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URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2025.10.007

https://www.lchc.cn/EN/Y2025/V40/I10/918

Figures/Tables 4

References 20

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组别	例数	回盲部插管	息肉回收	黏膜下层累积损伤	息肉整块切除	全切切除率
高频电切除组	60	51(85.00)	60(100.00)	48(80.00)	54(90.00)	54(90.00)
机械切除组	60	58(96.67)	60(100.00)	37(61.67)	58(96.67)	58(96.67)
χ²值		4.904	-	4.880	2.142	2.142
P值		<0.05	-	<0.05	>0.05	>0.05

组别	例数	回盲部插管	息肉回收	黏膜下层累积损伤	息肉整块切除	全切切除率
高频电切除组	60	51(85.00)	60(100.00)	48(80.00)	54(90.00)	54(90.00)
机械切除组	60	58(96.67)	60(100.00)	37(61.67)	58(96.67)	58(96.67)
χ²值		4.904	-	4.880	2.142	2.142
P值		<0.05	-	<0.05	>0.05	>0.05

组别	例数	手术时间 (min)	术中出血量 (ml)	术后首次排气时间 (h)	术后首次排便时间 (h)	住院时长 (d)
高频电切除组	60	49.18±2.85	24.18±3.81	30.38±2.84	39.48±1.84	6.82±1.12
机械切除组	60	35.28±2.98	18.38±2.81	23.54±3.81	28.49±3.91	5.19±1.22
t值		26.111	9.489	11.149	19.699	7.623
P值		<0.05	<0.05	<0.05	<0.05	<0.05

组别	例数	手术时间 (min)	术中出血量 (ml)	术后首次排气时间 (h)	术后首次排便时间 (h)	住院时长 (d)
高频电切除组	60	49.18±2.85	24.18±3.81	30.38±2.84	39.48±1.84	6.82±1.12
机械切除组	60	35.28±2.98	18.38±2.81	23.54±3.81	28.49±3.91	5.19±1.22
t值		26.111	9.489	11.149	19.699	7.623
P值		<0.05	<0.05	<0.05	<0.05	<0.05

组别	例数	IFABP(μg/L)		VIP(ng/L)		DAO(U/ml)
组别	例数	术前	术后3 d	术前	术后3 d	术前	术后3 d
高频电切除组	60	94.18±10.25	73.81±8.23	59.49±3.85	23.71±2.81	83.18±3.81	62.81±2.81
机械切除组	60	94.48±11.22	62.74±10.22	59.48±3.11	19.28±4.91	83.19±2.85	59.18±2.81
t值		0.152	6.534	0.015	6.056	0.016	7.705
P值		>0.05	<0.05	>0.05	<0.05	>0.05	<0.05