Safety of cold snare polypectomy for duodenal adenomas in familial adenomatous polyposis: a prospective exploratory study

Background  Cold snare polypectomy (CSP) to remove multiple duodenal adenomas (MDAs) in patients with familial adenomatous polyposis (FAP) could be an effective and less invasive method than more extensive surgery. The aim of the present study was to determine the safety of this procedure. Methods  This prospective exploratory study included 10 consecutive patients with FAP and MDAs who underwent CSP for as many as 50 duodenal adenomas. The primary outcome was the incidence of severe adverse events. Results  10 patients were enrolled and underwent 332 CSPs from June 2016 to January 2017. The median procedure time was 33 minutes (range 25 – 53), and the median number of polyps removed during a single session was 35 (range 10 – 50). Most of the removed polyps were ≤ 10 mm. None of the 10 patients experienced a severe adverse event. One patient developed arterial bleeding during the procedure, but it was easily managed using hemoclips. Conclusions  CSP for MDAs in patients with FAP was safe. The long-term efficacy of this procedure should be investigated.