Cold snare polypectomy versus hot snare polypectomy in endoscopic treatment of small polyps

Abstract

Background/Aims: The removal of small colon polyps by hot snare polypectomy (HP) is a commonly used method. Polypectomy with a cold snare (CP) has been increasingly utilized in recent years. Each method has its own advantages and disadvantages. Herein, we explored the efficacy and safety of each method. Materials and Methods: Between January 1, 2012 and June 30, 2012, 97 consecutive patients with small colorectal polyps ranging from 5-9 mm in size were separated into either the CP or HP group. Demographic data, the duration of polypectomy, and pathology reports were recorded. Results: Seventy-seven polyps were removed from 49 patients in the CP group, and 71 polyps were removed from 48 patients in the HP group. There was no significant difference between the groups with respect to gender, age distribution, number of polyps, or indications for colonoscopy. The mean polyp size was 7.21±1.4 mm in the CP group and 7.56±1.45 mm in the HP group (p=0.111). There was a significant difference in the mean procedure time between the two groups (CP, 25.71±4.3 sec; HP, 70.28±11.3 sec, p<0.001). One patient (1.3/1.4%) from each group developed post-polypectomy bleeding that required treatment. Histological evaluation revealed that 10 of the polyps (6.75%) were advanced adenomas. Pathological examination showed that the polyps were not completely removed in 4 patients (5.13%) in the CP group and 4 patients (5.63%) in the HP group (p=0.89). Conclusion: CP is an effective and safe method that shortens the polypectomy duration in small polyps (≤9 mm) compared to HP.

Histopathological analysis of cold snare polypectomy and its indication for colorectal polyps 10–14 mm in diameter

“…Our study confirmed and concurs with previous studies that CSP is a very safe procedure and a justifiable choice of procedure in colorectal . The postoperative hemorrhage rate was 0.1% even though 52 patients (15.2%) were receiving various antithrombotic treatments.…”

“…From 1992 to 2016, several studies on CSP have been published . Most studies had a relatively small sample size (<300 polyps) and targeted small polyps (<10 mm in diameter).…”

“…Compared to standard polypectomy, CSP has been reported as a safe procedure even in patients taking warfarin . Furthermore, the procedural time is significantly shorter with CSP than with standard polypectomy …”

Efficacy and safety of cold versus hot snare polypectomy for resecting small colorectal polyps: Systematic review and meta‐analysis

“…Based on the title and abstract, 816 irrelevant studies were excluded. Evaluation of the full text of the remaining studies excluded eight more: observational studies ( n = 4), comparison with cold forceps ( n = 3) and comparison with hot forceps ( n = 1) . The remaining eight studies were included in this meta‐analysis …”

Complications of cold versus hot snare polypectomy of 10–20 mm polyps: A retrospective cohort study

“…Cold snare polypectomy (CSP) is increasingly being used as the preferred method of polypectomy, particularly for small polyps . An increasing number of publications suggest that CSP is at least as safe as HSP, particularly for polyps <10 mm in size, and efficacy data are trending in the same direction . The aim of this study was to evaluate the intraprocedural and postprocedural adverse events following CSP versus HSP for sessile polyps 10–20 mm in size.…”