Histological outcomes between hot and cold snare polypectomy for small colorectal polyps

Area of Science:

• Gastroenterology
• Endoscopic Procedures
• Colorectal Cancer Prevention

Background:

• Colorectal polyps require complete resection to prevent malignant transformation.
• Endoscopic polypectomy is the standard treatment for colorectal polyps.
• Choosing the optimal polypectomy technique is crucial for effective treatment.

Purpose of the Study:

• To compare the efficacy of hot snare polypectomy versus cold snare polypectomy.
• To determine the complete resection rates for small colorectal polyps using both methods.
• To identify factors influencing complete polyp resection.

Main Methods:

• Retrospective review of 233 patients undergoing polypectomy for 461 colorectal polyps (≤10 mm).
• Comparison of histological complete resection rates between hot snare polypectomy (n=137) and cold snare polypectomy (n=324).
• Multivariate analysis to identify independent factors for complete resection.

Main Results:

• Hot snare polypectomy demonstrated a significantly higher complete resection rate (70.5%) than cold snare polypectomy (47.3%).
• This difference was significant for polyps ≥6 mm (69.0% vs. 43.5%), but not for polyps ≤5 mm (81.3% vs. 53.4%).
• Hot snare use, smaller lesion size, and left colon location were independent predictors of complete resection.

Conclusions:

• Hot snare polypectomy is more effective for achieving complete resection of larger subcentimeter colorectal polyps (6-10 mm).
• The choice of polypectomy technique may influence resection success based on polyp size.
• Further research could explore technique optimization for smaller polyps.