{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T07:55:34Z","timestamp":1791705334031,"version":"4.3.4"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"11","license":[{"start":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T00:00:00Z","timestamp":1693785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004622","name":"KWF Kankerbestrijding","doi-asserted-by":"crossref","award":["13676"],"award-info":[{"award-number":["13676"]}],"id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n            Background and study aims In patients with familial adenomatous\n      polyposis (FAP), endoscopic resection of duodenal adenomas is commonly performed to prevent\n      cancer and prevent or defer duodenal surgery. However, based on studies using different\n      resection techniques, adverse events (AEs) of polypectomy in the duodenum can be significant.\n      We hypothesized that cold snare polypectomy (CSP) is a safe technique for duodenal adenomas in\n      FAP and evaluated its outcomes in our centers.<\/jats:p><jats:p>\n            Patients and methods We performed a prospective international\n      cohort study including FAP patients who underwent CSP for one or more superficial\n      non-ampullary duodenal adenomas of any size between 2020 and 2022. At that time, this\n      technique was common practice in our centers for superficial duodenal adenomas. The primary\n      outcome was the occurrence of intraprocedural and post-procedural AEs.<\/jats:p><jats:p>\n            ResultsIn total, 133 CSPs were performed in 39 patients with FAP\n      (1\u201318 per session). Median adenoma size was 10 mm (interquartile range 8\u201315 mm), ranging from\n      5 to 40 mm; 27 adenomas were \u226520 mm (20%). Of the 133 polypectomies, 109 (82%) were performed\n      after submucosal injection. Sixty-one adenomas (46%) were resected en bloc and 72 (54%)\n      piecemeal. Macroscopic radical resection was achieved for 129 polypectomies (97%). Deep mural\n      injury type II occurred in three polyps (2%) with no delayed perforation after prophylactic\n      clipping. There were no clinically significant bleeds, perforations or other post-procedural\n      AEs. Histopathology showed low-grade dysplasia in all 133 adenomas.<\/jats:p><jats:p>\n            Conclusions CSP for (multiple) superficial non-ampullary duodenal\n      adenomas in FAP seems feasible and safe. Long-term prospective research is needed to evaluate\n      whether protocolized duodenal polypectomies prevent cancer and surgery.<\/jats:p>","DOI":"10.1055\/a-2165-7436","type":"journal-article","created":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T23:11:40Z","timestamp":1693869100000},"page":"E1056-E1062","source":"Crossref","is-referenced-by-count":13,"title":["Cold snare polypectomy for duodenal adenomas in familial adenomatous polyposis: a prospective international cohort study"],"prefix":"10.1055","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct04677998","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1991-1117","authenticated-orcid":false,"given":"Arthur S.","family":"Aelvoet","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Cancer Center Amsterdam, Amsterdam, the Netherlands"},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9333-0399","authenticated-orcid":false,"given":"John G.","family":"Karstensen","sequence":"additional","affiliation":[{"name":"Gastrounit, Copenhagen University Hospital - Amager and Hvidovre, Danish Polyposis Registry, Hvidovre, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara A.J.","family":"Bastiaansen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Cancer Center Amsterdam, Amsterdam, the Netherlands"},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique E.","family":"van Leerdam","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands"},{"name":"Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesc","family":"Balaguer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), University of Barcelona, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Kaminski","sequence":"additional","affiliation":[{"name":"Department of Oncological Gastroenterology and Department of Cancer Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roel","family":"Hompes","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Cancer Center Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick M.M.","family":"Bossuyt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Data Science, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Ricciardiello","sequence":"additional","affiliation":[{"name":"Policlinico di Sant'Orsola, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy"},{"name":"Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8626-188X","authenticated-orcid":false,"given":"Andrew","family":"Latchford","sequence":"additional","affiliation":[{"name":"Polyposis Registry, St Mark's Hospital, Harrow, United Kingdom"},{"name":"Department of Surgery and Cancer, Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Jover","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica ISABIAL, Universidad Miguel Hern\u00e1ndez, Servicio de Medicina Digestiva, Hospital General Universitario de Alicante, Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5636-8865","authenticated-orcid":false,"given":"Maria","family":"Daca-Alvarez","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), University of Barcelona, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9739-4998","authenticated-orcid":false,"given":"Maria","family":"Pellis\u00e9","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD), University of Barcelona, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4363-0745","authenticated-orcid":false,"given":"Evelien","family":"Dekker","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Cancer Center Amsterdam, Amsterdam, the Netherlands"},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"European FAP Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,11,10]]},"reference":[{"key":"ref1","volume-title":"Familial polyposis coli: family studies, histopathology, differential diagnosis\n          and results of treatment","author":"HJR Bussey","year":"1975"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1055\/s-0029-1214719","article-title":"Surveillance and treatment of duodenal adenomatosis in familial adenomatous\n          polyposis","volume":"41","author":"A 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Groves","year":"2002","journal-title":"Gut"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1136\/jmedgenet-2017-104545","article-title":"Extracolonic cancer risk in Dutch patients with APC (adenomatous polyposis\n          coli)-associated polyposis","volume":"55","author":"Z Ghorbanoghli","year":"2018","journal-title":"J Med Genet"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1016\/j.surg.2019.05.060","article-title":"Comparison of pancreas-sparing duodenectomy (PSD) and pancreatoduodenectomy (PD)\n          for the management of duodenal polyposis syndromes","volume":"166","author":"RM Walsh","year":"2019","journal-title":"Surgery"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1016\/j.hpb.2022.04.004","article-title":"Pancreas-preserving total duodenectomy for advanced duodenal polyposis in patients\n          with familial adenomatous polyposis: short and long-term outcomes","volume":"24","author":"AS Aelvoet","year":"2022","journal-title":"HPB (Oxford)"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.gie.2020.05.065","article-title":"Endoscopic management of duodenal adenomas in patients with familial adenomatous\n          polyposis","volume":"93","author":"VH Roos","year":"2021","journal-title":"Gastrointest Endosc"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1016\/j.gie.2014.03.012","article-title":"Endoscopic treatment of severe duodenal polyposis as an alternative to surgery for\n          patients with familial adenomatous polyposis","volume":"80","author":"D Moussata","year":"2014","journal-title":"Gastrointest Endosc"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1055\/a-1983-5963","article-title":"Efficacy and safety of intensive endoscopic intervention for multiple duodenal\n          adenomas in patients with familial adenomatous polyposis: A prospective cohort\n          study","volume":"55","author":"Y Takeuchi","year":"2023","journal-title":"Endoscopy"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1055\/s-0043-102569","article-title":"Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of\n          Gastrointestinal Endoscopy (ESGE) Clinical Guideline","volume":"49","author":"M Ferlitsch","year":"2017","journal-title":"Endoscopy"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/j.gie.2013.08.040","article-title":"Removal of small colorectal polyps in anticoagulated patients: a prospective\n          randomized comparison of cold snare and conventional polypectomy","volume":"79","author":"A Horiuchi","year":"2014","journal-title":"Gastrointest Endosc"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"E345","DOI":"10.1111\/j.1463-1318.2011.02696.x","article-title":"A prospective randomized comparison of cold vs hot snare polypectomy in the\n          occurrence of postpolypectomy bleeding in small colonic polyps","volume":"13","author":"GA Paspatis","year":"2011","journal-title":"Colorectal disease : the official journal of the Association of Coloproctology of\n          Great Britain and Ireland"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1159\/000323959","article-title":"Prospective randomized comparison of cold snare polypectomy and conventional\n          polypectomy for small colorectal polyps","volume":"84","author":"Y Ichise","year":"2011","journal-title":"Digestion"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1016\/j.gie.2022.03.006","article-title":"Cold versus hot snare resection with or without submucosal injection of 6- to\n          15-mm colorectal polyps: a randomized controlled trial","volume":"96","author":"DK Rex","year":"2022","journal-title":"Gastrointest Endosc"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1055\/s-0043-124765","article-title":"Safety of cold snare polypectomy for duodenal adenomas in familial adenomatous\n          polyposis: a prospective exploratory study","volume":"50","author":"K Hamada","year":"2018","journal-title":"Endoscopy"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1016\/j.gie.2021.12.018","article-title":"Outcomes of cold snare piecemeal EMR for nonampullary small-bowel adenomas larger\n          than 1 cm: a retrospective study","volume":"95","author":"DT Dang","year":"2022","journal-title":"Gastrointest Endosc"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1016\/j.gie.2022.05.007","article-title":"Comparison of cold snare and hot snare polypectomy for the resection of sporadic\n          nonampullary duodenal adenomas","volume":"96","author":"M Trivedi","year":"2022","journal-title":"Gastrointest Endosc"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1136\/gutjnl-2022-327171","article-title":"Cold versus hot EMR for large duodenal adenomas","volume":"71","author":"A Repici","year":"2022","journal-title":"Gut"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1055\/s-0043-107028","article-title":"Cold polypectomy for duodenal adenomas: a prospective clinical trial","volume":"49","author":"D Maruoka","year":"2017","journal-title":"Endoscopy"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.1016\/j.gie.2023.01.040","article-title":"Cold snare EMR for the removal of large duodenal adenomas","volume":"97","author":"H Wang","year":"2023","journal-title":"Gastrointest Endosc"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1055\/a-1442-2395","article-title":"Endoscopic management of superficial nonampullary duodenal tumors: European\n          Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"53","author":"G Vanbiervliet","year":"2021","journal-title":"Endoscopy"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1016\/j.gie.2021.11.038","article-title":"Novel classification for adverse events in GI endoscopy: the AGREE\n          classification","volume":"95","author":"KJ Nass","year":"2022","journal-title":"Gastrointest Endosc"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1779","DOI":"10.1136\/gutjnl-2015-309848","article-title":"Deep mural injury and perforation after colonic endoscopic mucosal resection: a\n          new classification and analysis of risk factors","volume":"66","author":"NG Burgess","year":"2017","journal-title":"Gut"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"E386","DOI":"10.1055\/a-2011-1933","article-title":"Personalized endoscopic surveillance and intervention protocols for patients with\n          familial adenomatous polyposis: the European FAP 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