Polypectomy technique for small colorectal polyps may impact delayed bleeding risk

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Cold snare polypectomy (CSP) for small colorectal polyps significantly reduces the risk for delayed post-polypectomy bleeding compared to hot snare polypectomy (HSP), according to the results of a randomized control trial.

The study included 4270 patients ≥ 40 years of age with polyps measuring between 4 mm to 10 mm randomized to receive CSP (n = 2137) or HSP (n = 2133).

The mean time to complete the polypectomy was 119.0 seconds in the CSP and 162.9 seconds in the HSP group; There was no difference in successful tissue retrieval, en bloc resection, and complete histologic resection.

The rate of delayed bleeding and severe delayed bleeding was lower in the CSP group (0.4% and 0.05%, respectively) compared with the HSP group (1.5% and 0.4%, respectively). There were also fewer emergency service visits in the CSP group compared with the HSP group (0.2% vs 0.6%).

Chang LC, Chang CY, Chen CY, et al. Cold Versus Hot Snare Polypectomy for Small Colorectal Polyps : A Pragmatic Randomized Controlled Trial. Ann Intern Med. 2023;doi: 10.7326/M22-2189. Epub ahead of print. PMID: 36802753.