[Resection of small colorectal polyps using a dedicated cold resection snare]

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• German guidelines permit biopsy forceps for small colorectal polyp resection.
• Surveillance colonoscopy is recommended if complete resection is unproven.
• Cold snare resection offers an effective method for complete removal of small polyps.

Purpose of the Study:

• To develop and evaluate a novel snare for cold resection of colorectal polyps.
• To assess the efficacy and safety of cold snare resection for diminutive polyps.

Main Methods:

• A monocentric observational trial was conducted.
• Cold snare resection was performed on colorectal polyps <10mm without submucosal injection.
• Histological analysis determined the complete resection rate (R0).

Main Results:

• 99 polyps were resected in 58 patients; mean polyp size was 5.3mm.
• The overall R0 resection rate was high, with 92.5% of adenomas completely resected en bloc.
• Specific R0 rates were 90% for polyps 1-4mm and 94% for polyps 5-10mm.
• No complications such as bleeding or perforation were observed.

Conclusions:

• A dedicated cold resection snare achieves a high R0 resection rate for small colorectal polyps.
• Cold snare resection minimizes piecemeal resections, improving outcomes for small polyp removal.