Cold snare polypectomy: Indications, devices, techniques, outcomes and future.

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Cancer Prevention

Background:

• Colonoscopy is crucial for colon cancer prevention through precancerous lesion removal.
• Cold snare and hot snare polypectomy show similar polyp retrieval and resection rates.
• Cold snare polypectomy demonstrates lower delayed bleeding rates, particularly in patients on antithrombotic agents.

Purpose of the Study:

• To evaluate the efficacy and safety of cold snare polypectomy for colorectal polyp removal.
• To compare cold snare polypectomy with hot snare polypectomy regarding bleeding risk and completeness of resection.
• To identify optimal techniques and potential future applications for cold snare polypectomy.

Main Methods:

• Review of existing literature comparing cold snare and hot snare polypectomy techniques.
• Analysis of histological data on tissue damage and vessel integrity.
• Discussion of clinical outcomes, including bleeding rates and polyp retrieval success.

Main Results:

• Cold snare polypectomy is associated with significantly lower rates of delayed bleeding than hot snare polypectomy.
• Complete polyp excision may be more consistently achieved with thin-wire dedicated cold snares.
• Potential for fragmentation of small polyps and challenges in confirming complete resection exist with cold snare techniques.

Conclusions:

• Cold snare polypectomy is a primary method for colorectal polyps <10 mm, especially for patients on antithrombotic agents.
• Thin-wire dedicated cold snares may offer superior completeness of excision.
• Development of an endoscopy biomarker is needed to ensure complete removal of polyps ≤10 mm.