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      Outcomes of thin versus thick-wire snares for cold snare polypectomy: a systematic review and meta-analysis

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          Abstract

          Background/Aims

          Cold snare polypectomy (CSP) is commonly used for the resection of colorectal polyps ≤10 mm. Data regarding the influence of snare type on CSP effectiveness are conflicting. Hence, this meta-analysis aimed to compare the outcomes and safety of thin- and thick-wire snares for CSP.

          Methods

          A comprehensive search of the literature published between 2000 and 2021 was performed of various databases for comparative studies evaluating the outcomes of thin- versus thick-wire snares for CSP.

          Results

          Five studies with data on 1,425 polyps were included in the analysis. The thick-wire snare was comparable to the thin-wire snare with respect to complete histological resection (risk ratio [RR], 1.03; 95% confidence interval [CI], 0.97–1.09), overall bleeding (RR, 0.98; 95% CI, 0.40–2.40), polyp retrieval (RR, 1.01; 95% CI, 0.97–1.04), and involvement of submucosa in the resection specimen (RR, 1.28; 95% CI, 0.72–2.28). There was no publication bias and a small study effect, and the relative effects remained the same in the sensitivity analysis.

          Conclusions

          CSP using a thin-wire snare has no additional benefit over thick-wire snares in small colorectal polyps. Factors other than snare design may play a role in improving CSP outcomes.

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          Most cited references29

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          Matthew J L Page, Joanne E McKenzie, Patrick Bossuyt … (2025)
          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
          Article 0 comments Cited 14665 times – based on 0 reviews     Review now
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            The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials

            Julian P. T. Higgins, Douglas G. Altman, Peter C. Gøtzsche … (2014)
            Flaws in the design, conduct, analysis, and reporting of randomised trials can cause the effect of an intervention to be underestimated or overestimated. The Cochrane Collaboration’s tool for assessing risk of bias aims to make the process clearer and more accurate
            Article 0 comments Cited 7554 times – based on 0 reviews     Review now
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              Rayyan—a web and mobile app for systematic reviews

              Mourad Ouzzani, Hossam Hammady, Zbys Fedorowicz … (2017)
              Background Synthesis of multiple randomized controlled trials (RCTs) in a systematic review can summarize the effects of individual outcomes and provide numerical answers about the effectiveness of interventions. Filtering of searches is time consuming, and no single method fulfills the principal requirements of speed with accuracy. Automation of systematic reviews is driven by a necessity to expedite the availability of current best evidence for policy and clinical decision-making. We developed Rayyan (http://rayyan.qcri.org), a free web and mobile app, that helps expedite the initial screening of abstracts and titles using a process of semi-automation while incorporating a high level of usability. For the beta testing phase, we used two published Cochrane reviews in which included studies had been selected manually. Their searches, with 1030 records and 273 records, were uploaded to Rayyan. Different features of Rayyan were tested using these two reviews. We also conducted a survey of Rayyan’s users and collected feedback through a built-in feature. Results Pilot testing of Rayyan focused on usability, accuracy against manual methods, and the added value of the prediction feature. The “taster” review (273 records) allowed a quick overview of Rayyan for early comments on usability. The second review (1030 records) required several iterations to identify the previously identified 11 trials. The “suggestions” and “hints,” based on the “prediction model,” appeared as testing progressed beyond five included studies. Post rollout user experiences and a reflexive response by the developers enabled real-time modifications and improvements. The survey respondents reported 40% average time savings when using Rayyan compared to others tools, with 34% of the respondents reporting more than 50% time savings. In addition, around 75% of the respondents mentioned that screening and labeling studies as well as collaborating on reviews to be the two most important features of Rayyan. As of November 2016, Rayyan users exceed 2000 from over 60 countries conducting hundreds of reviews totaling more than 1.6M citations. Feedback from users, obtained mostly through the app web site and a recent survey, has highlighted the ease in exploration of searches, the time saved, and simplicity in sharing and comparing include-exclude decisions. The strongest features of the app, identified and reported in user feedback, were its ability to help in screening and collaboration as well as the time savings it affords to users. Conclusions Rayyan is responsive and intuitive in use with significant potential to lighten the load of reviewers.
              Article 0 comments Cited 4557 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Endosc
                Journal ID (iso-abbrev): Clin Endosc
                Journal ID (publisher-id): CE
                Title: Clinical Endoscopy
                Publisher: Korean Society of Gastrointestinal Endoscopy
                ISSN (Print): 2234-2400
                ISSN (Electronic): 2234-2443
                Publication date (Print): November 2022
                Publication date (Electronic): 9 November 2022
                Volume: 55
                Issue: 6
                Pages: 742-750
                Affiliations
                [1 ]Nizam’s Institute of Medical Sciences, Hyderabad, India
                [2 ]Postgraduate Institute of Medical Education and Research, Chandigarh, India
                [3 ]Seth GS Medical College and KEM Hospital, Mumbai, India
                [4 ]Department of Digestive Diseases and Clinical Nutrition, TATA Memorial Hospital, Mumbai, India
                Author notes
                Correspondence: Sridhar Sundaram Department of Digestive Diseases and Clinical Nutrition, TATA Memorial Hospital, Homi Bhabha National Institute, Dr. E Borges Road, Parel, Mumbai 400012, India E-mail: drsridharsundaram@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-9626-5243
                http://orcid.org/0000-0002-5633-0338
                http://orcid.org/0000-0002-7902-7390
                http://orcid.org/0000-0002-2946-8534
                Article
                Publisher ID: ce-2022-141
                DOI: 10.5946/ce.2022.141
                PMC ID: 9726435
                PubMed ID: 36347525
                SO-VID: dd280524-6711-479e-97b4-09c8bd583334
                Copyright © Copyright © 2022 Korean Society of Gastrointestinal Endoscopy
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 27 April 2022
                Date revision received : 28 May 2022
                Date accepted : 27 June 2022
                Categories
                Subject: Systematic Review and Meta-Analysis

                ScienceOpen disciplines: Radiology & Imaging
                Keywords: cold snare polypectomy,colorectal polyp,dedicated snare,histological resection,meta-analysis
                Data availability:
                ScienceOpen disciplines: Radiology & Imaging
                Keywords: cold snare polypectomy, colorectal polyp, dedicated snare, histological resection, meta-analysis

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