Cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps: a multicenter randomized...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Cancer Prevention

Background:

• Cold snare polypectomy (CSP) is the standard for small colorectal polyp resection.
• Limited data exists on cold endoscopic mucosal resection (EMR) for small polyps.
• This study compares cold EMR and CSP efficacy and safety.

Purpose of the Study:

• To compare the efficacy and safety of cold EMR versus CSP for small colorectal polyps.
• To evaluate complete polyp resection rates and adverse events.
• To assess the impact on total procedure time.

Main Methods:

• Multicenter randomized trial (January 2018 - February 2021).
• Patients with 6-10 mm polyps randomized to CSP or cold EMR.
• Complete resection assessed via post-polypectomy biopsies; adverse events and procedure time recorded.

Main Results:

• 425 polyps analyzed; no significant difference in complete resection rates (91.9% cold EMR vs. 89.8% CSP).
• Cold EMR significantly increased total procedure time (87.6s vs. 45.8s).
• Adverse event rates, including bleeding and perforation, were similar and low between groups.

Conclusions:

• Cold EMR and CSP offer comparable complete resection rates and safety profiles for small colorectal polyps.
• CSP is more time-efficient than cold EMR.
• CSP remains a preferred method for small polyp resection due to shorter procedure times.