Cold snare excision is a safe method for diminutive colorectal polyps

Area of Science:

• Gastroenterology
• Endoscopic procedures
• Colorectal surgery

Background:

• Cold snare excision (CSE) is a standard technique for removing diminutive colorectal polyps.
• Accurate polyp sizing is crucial for determining the appropriate resection method and assessing hemostasis.
• The open-biopsy forceps technique (OBFT) may underestimate polyp size compared to other methods.

Purpose of the Study:

• To investigate the correlation between polyp size measured by a specialized measuring system (SMS) and post-excision bleeding time (BTCSE) after CSE.
• To evaluate the accuracy of OBFT in estimating polyp size for CSE.
• To establish an appropriate measuring method for guiding CSE procedures.

Main Methods:

• Eighty patients with single diminutive polyps underwent CSE.
• Polyp size was initially assessed using OBFT and then precisely measured using the SMS.
• Bleeding time of the CSE (BTCSE) was recorded post-excision for each polyp.

Main Results:

• Fifteen percent of polyps initially measured ≤5 mm by OBFT were found to be ≥6 mm by SMS.
• A correlation was observed between SMS measurements and BTCSE for polyps ≤6 mm.
• Polyps ≥7 mm by SMS required prolonged hemostasis (>10 minutes) and additional electrocoagulation.

Conclusions:

• CSE is a safe and effective method for polyps measuring ≤6 mm by SMS.
• The SMS provides a more accurate assessment of polyp size than OBFT, crucial for predicting hemostasis.
• Accurate polyp sizing using SMS is essential for optimizing CSE outcomes and patient safety.