An international polypectomy practice survey.

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Cancer Prevention

Background:

• Cold snare polypectomy (CSP) is increasingly recommended for small and diminutive colorectal polyps.
• International practice patterns regarding polypectomy techniques require updated understanding.

Purpose of the Study:

• To assess the adoption rate of CSP among endoscopists globally.
• To identify current polypectomy practices for various colorectal polyp sizes (1–20 mm).
• To understand practice evolution and perceptions of different polypectomy methods.

Main Methods:

• An international online survey distributed through major gastroenterology and endoscopy societies.
• 808 endoscopists participated, reporting on their predominant polypectomy techniques for different polyp sizes.
• Data collected on CSP uptake over the past five years and perceived benefits/concerns.

Main Results:

• CSP is the predominant technique for 4–10 mm colorectal polyps (67.0% for 4–5 mm, 55.2% for 6–10 mm).
• Cold forceps dominate for 1–3 mm polyps (78.4%), while hot snare polypectomy (HSP) is primary for 10–20 mm polyps (92.5%).
• 87.5% of endoscopists reported increased CSP use in the last five years.

Conclusions:

• A significant increase in CSP utilization for colorectal polyp removal has been observed.
• CSP is now the leading approach for 4–10 mm polyps, with HSP preferred for larger ones.
• Current clinical practices align with recent endoscopic guidelines for colorectal polypectomy.