Hot snare polypectomy versus endoscopic mucosal resection for small colorectal polyps: a randomized controlled trial

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Cancer Prevention

Background:

• Small colorectal polyps (5-10 mm) with neoplastic features require effective resection.
• Comparing endoscopic mucosal resection (EMR) and hot snare polypectomy (HSP) is crucial for optimizing polyp removal techniques.

Purpose of the Study:

• To compare the efficacy of EMR and HSP in achieving complete resection of small colorectal polyps.
• To evaluate the incidence of adverse events associated with both EMR and HSP techniques.

Main Methods:

• A randomized study comparing HSP and EMR for small (5-10 mm) neoplastic colorectal polyps.
• EMR involved submucosal injection prior to hot snaring; HSP did not.
• Complete resection defined by absence of neoplastic tissue in follow-up biopsies; R0 resection by margin status.

Main Results:

• No significant difference in complete resection rates between HSP (96.4%) and EMR (95.5%).
• EMR demonstrated a significantly higher R0 resection rate (74.8%) compared to HSP (49.7%).
• Adverse event incidence was comparable between the HSP and EMR groups.

Conclusions:

• Complete resection rates for small colorectal polyps are similar for both HSP and EMR.
• EMR offers superior R0 resection rates, suggesting more effective margin-negative removal.
• Both techniques are viable options with comparable safety profiles for small polyp resection.