Effect of cold snare polypectomy for small colorectal polyps

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Colorectal cancer (CRC) poses a significant healthcare challenge, with 60%-80% originating from intestinal polyps.
• Endoscopic resection of polyps during colonoscopy is crucial for CRC prevention.
• Developing effective endoscopic polypectomy techniques is a key focus.

Purpose of the Study:

• To compare the efficacy and safety of cold snare polypectomy (CSP) versus hot snare polypectomy (HSP).
• To evaluate outcomes for colorectal polyps measuring 4-9 mm in diameter.

Main Methods:

• A comparative study involving 301 patients with colorectal polyps (4-9 mm) between January and December 2020.
• Patients were divided into two groups: CSP (n=154) and HSP (n=147).
• Key metrics included operating time, bleeding/perforation rates, titanium clip use, and complete resection rates.

Main Results:

• No significant differences in resection rates (93.4% for CSP vs. 94.5% for HSP).
• CSP demonstrated significantly lower titanium clip use (15.6% vs. 95.9%), shorter operating time (3.2 min vs. 5.6 min), and lower complication rates (0% bleeding/perforation vs. 2.0% bleeding/0.7% perforation).
• Included 249 patients (301 polyps) with no baseline differences in patient or polyp characteristics.

Conclusions:

• Cold snare polypectomy (CSP) achieves comparable tissue integrity and resection rates to hot snare polypectomy (HSP) for sessile colorectal polyps < 10 mm.
• CSP is associated with a lower rate of complications, including bleeding and perforation.
• CSP presents a safe and effective alternative for endoscopic polypectomy.