Cold snare excision is a safe method for diminutive colorectal polyps

Cold snare excision (CSE) has proved to be an effective method for the destruction of diminutive polyps of the colon and rectum. We investigated the correlation between polyp size and bleeding time at the resected end after CSE, and also an appropriate measuring method using CSE. Eighty patients with single polyps were examined. Each polyp was identified as being 5 mm in diameter or smaller using the open-biopsy forceps technique (OBFT). The size of the polyp was calculated using our measuring system (SMS). Of the polyps identified as being 5 mm in diameter or less using OBFT, 15% were 6 mm or more using the SMS. CSE was performed for each polyp, and the time taken for the hemostasis (bleeding time of the CSE; BTCSE) was determined. In seventy-seven polyps that were 6 mm or smaller in SMS, a correlation was noted between SMS and BTCSE. In three polyps that were 7 mm or more by SMS, hemostasis took 10 min or more after CSE, and required electrocoagulation. These results suggest that CSE is a safe method for the removal of polyps determined to be 6 mm in diameter or smaller using the SMS.