Colorectal cold snare polypectomy: Current standard technique and future perspectives

Article Gastroenterology & Hepatology

A Randomized Controlled Trial of Cold Snare Polypectomy Technique: Technique Matters More Than Snare Wire Diameter

Mayenaaz Sidhu et al.

Summary: Cold snare polypectomy is a safe and effective method for removing small adenomas. The diameter of the snare wire used does not significantly affect the rate of incomplete resection.

AMERICAN JOURNAL OF GASTROENTEROLOGY (2022)

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Article Gastroenterology & Hepatology

Safety and Efficacy of Cold Snare Polypectomy Without Submucosal Injection for Large Sessile Serrated Lesions: A Prospective Study

Yoshiaki Kimoto et al.

Summary: This study evaluated the safety and efficacy of cold snare polypectomy (CSP) for sessile serrated lesions (SSL) sized at least 10 mm. The results showed that CSP is a safe and effective treatment for SSLs of this size, with successful resection and no recurrence during follow-up.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2022)

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Article Gastroenterology & Hepatology

A Comparison of Incomplete Resection Rate of Large and Small Colorectal Polyps by Cold Snare Polypectomy

Xianzong Ma et al.

Summary: This study evaluated the safety and efficacy of cold snare polypectomy (CSP) for colorectal polyps between 5 and 15 mm in size. The results showed that CSP is a safe and effective method for removing colorectal polyps up to 15 mm in size, with a low incomplete resection rate.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2022)

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Article Gastroenterology & Hepatology

Repeat Cold Snare Polypectomy Can Be Performed for Recurrent Benign Lesions After Cold Snare Polypectomy

Naohisa Yoshida et al.

Summary: The study evaluated the feasibility of repeat cold snare polypectomy (CSP) for recurrence after CSP, showing that repeat CSP for benign lesions with a diameter of <= 10 mm is safe and effective.

DIGESTIVE DISEASES AND SCIENCES (2022)

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Editorial Material Gastroenterology & Hepatology

Should large sessile serrated lesions be treated with cold snare polypectomy?

Sho Suzuki et al.

DIGESTIVE ENDOSCOPY (2022)

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Article Gastroenterology & Hepatology

Guidelines for Colorectal Cold Polypectomy (supplement to Guidelines for Colorectal Endoscopic Submucosal Dissection/Endoscopic Mucosal Resection)

Toshio Uraoka et al.

Summary: The Japan Gastroenterological Endoscopy Society published the second edition of the guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection to ensure safe and effective endoscopic treatment. Supplementary guidelines for cold polypectomy were also established.

DIGESTIVE ENDOSCOPY (2022)

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Article Gastroenterology & Hepatology

Comparison of postpolypectomy bleeding events between cold snare polypectomy and hot snare polypectomy for small colorectal lesions: a large-scale propensity score-matched analysis

Hiroyuki Takamaru et al.

Summary: This study analyzed the rates of postpolypectomy bleeding (PPB) after cold snare polypectomy (CSP) and hot snare polypectomy (HSP). The results showed that for colorectal lesions <10 mm in diameter, the risk of PPB after CSP was significantly lower than that after HSP.

GASTROINTESTINAL ENDOSCOPY (2022)

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Article Gastroenterology & Hepatology

Managing bleeding risk after cold snare polypectomy in patients receiving direct-acting oral anticoagulants

Atsushi Morita et al.

Summary: This study compared the effect of continuing versus stopping DOACs on bleeding after cold snare polypectomy. The results showed that withholding DOACs only on the day of the procedure can reduce the risk of bleeding after the surgery.

GASTROINTESTINAL ENDOSCOPY (2022)

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Article Gastroenterology & Hepatology

Evaluation of cold snare polypectomy for small pedunculated (Ip) polyps with thin stalks: a prospective clinical feasibility study

Jun Arimoto et al.

Summary: A prospective study evaluated the safety of cold snare polypectomy (CSP) for pedunculated (Ip) polyps <10 mm with thin stalks, showing that CSP was safe and had good outcomes. Pedunculated polyps may be included as an indication for CSP, but further prospective, randomized studies are needed for confirmation and inclusion in future guidelines.

SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY (2022)

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Review Gastroenterology & Hepatology

Safety of cold snare polypectomy with periprocedural antithrombotic agents for colorectal polyps: a systematic review and meta-analysis

Jen-Hao Yeh et al.

Summary: The study findings suggest that CSP with periprocedural antiplatelet agents and warfarin may be a safe option for diminutive polyps. However, caution should be exercised when using DOACs or multiple agents, as they carry higher bleeding risks even with hemoclipping.

THERAPEUTIC ADVANCES IN GASTROENTEROLOGY (2022)

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Article Gastroenterology & Hepatology

Risk Factors of Delayed Bleeding After Cold Snare Polypectomy for Colorectal Polyps: A Multicenter Study

Yoshikazu Inagaki et al.

Summary: The incidence rate of delayed bleeding after cold snare polypectomy was very low at 0.14%, with antithrombotic drug use, polyp size, location, and morphology being significant risk factors for its occurrence.

DIGESTIVE DISEASES AND SCIENCES (2022)

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Review Gastroenterology & Hepatology

Safety and efficacy of cold versus hot snare polypectomy including colorectal polyps ≥1 cm in size

Yoji Takeuchi et al.

Summary: Cold snare polypectomy (CSP) is a rapidly spreading technique worldwide, known as the Cold Revolution. Studies have shown that complete resection rates (CRRs) are similar regardless of electrocautery use, with controversy surrounding the effectiveness of submucosal injection for achieving better outcomes. Cold procedures carry comparable or higher risks of intraprocedural bleeding compared to hot procedures, but lower risks of delayed bleeding, particularly in patients on anticoagulants. Large sessile serrated lesions (SSLs) are suitable candidates for CSP, while large adenomas are not recommended due to incision depth and local recurrence rates. The procedure is considered appropriate for sub-centimeter colorectal low-grade adenomas. Further prospective studies are needed to confirm the clinical relevance of CSP for large SSLs.

DIGESTIVE ENDOSCOPY (2022)

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Article Gastroenterology & Hepatology

Resection depth for small colorectal polyps comparing cold snare polypectomy, hot snare polypectomy and underwater endoscopic mucosal resection

Junki Toyosawa et al.

Summary: In this retrospective study comparing different methods of removing small colorectal polyps, underwater endoscopic mucosal resection (UEMR) was found to be the best option for preserving submucosal tissue without the need for injection.

ENDOSCOPY INTERNATIONAL OPEN (2022)

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Article Gastroenterology & Hepatology

Efficacy of specimen pasting after cold snare polypectomy for pathological evaluation of horizontal margins

Takuya Ikeda et al.

Summary: Pasting CSP specimens on paper is important for accurate pathological examination of horizontal margins.

ENDOSCOPY INTERNATIONAL OPEN (2022)

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Article Gastroenterology & Hepatology

Snare devices with thinner loop wire may provide higher performance for cold snare polypectomy in an experimental model

Satoshi Ono et al.

Summary: This study evaluated the characteristics of seven types of snare devices, including stiffness, cutting quality, and the change in force required for cutting depending on sheath shape. The study found a positive correlation between loop wire diameter and cutting force, and that snare devices with a thicker diameter were able to cut rougher surfaces. Thinner loop wire may provide higher performance in cold snare polypectomy.

ENDOSCOPY INTERNATIONAL OPEN (2022)

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Article Gastroenterology & Hepatology

Management of Less Than 10-mm-Sized Pedunculated (Ip) Polyps with Thin Stalk: Hot Snare Polypectomy Versus Cold Snare Polypectomy

Jun Arimoto et al.

Summary: This study found that CSP is safer than HSP for Ip polyps measuring less than 10 mm in diameter. Despite a higher rate of immediate bleeding during CSP, the incidence of DPPB was 0% after CSP.

DIGESTIVE DISEASES AND SCIENCES (2021)

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Article Gastroenterology & Hepatology

Effectiveness of suction valve button removal in retrieving resected colon polyps for better histological assessment: Propensity score matching analysis

Yoshihiro Kishida et al.

Summary: This study showed that removing the suction valve button during polyp retrieval can effectively reduce fragmentation rates and histological unclear margins.

DIGESTIVE ENDOSCOPY (2021)

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Article Gastroenterology & Hepatology

Histopathologic features and fragmentation of polyps with cold snare defect protrusions

Tatsuya Ishii et al.

Summary: In this study, it was found that the occurrence of CSDPs is associated with polyp fragmentation, less muscularis mucosa on the stump, as well as large polyp and specimen size. The presence of CSDP can serve as a good indicator of polyp fragmentation in clinical practice.

GASTROINTESTINAL ENDOSCOPY (2021)

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Article Gastroenterology & Hepatology

Is Submucosal Injection Helpful in Cold Snare Polypectomy for Small Colorectal Polyps?

Ji Hyun Song et al.

Summary: This study found that the effect of submucosal injection in CSP was not significant for small colorectal polyps, with no significant difference in complete resection rate and bleeding rate between CS-EMR and CSP methods. The use of warfarin and direct-acting oral anticoagulants significantly increased the risk of bleeding.

CLINICAL ENDOSCOPY (2021)

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Article Gastroenterology & Hepatology

Colonoscopy screening and surveillance guidelines

Yutaka Saito et al.

Summary: The guidelines for colonoscopy screening and surveillance were developed by the Japan Gastroenterological Endoscopy Society based on scientific methods and expert consensus. Limited high-level evidence in this field required a focus on expert opinions. The guidelines consist of 20 clinical questions and eight background knowledge topics as the current guiding principles.

DIGESTIVE ENDOSCOPY (2021)

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Article Gastroenterology & Hepatology

743 COLD OR HOT SNARE POLYPECTOMY FOR SMALL COLORECTAL NEOPLASMS TO PREVENT DELAYED BLEEDING: A MULTICENTER RANDOMIZED CONTROLLED TRIAL (TACOS TRAIL)

Li-Chun Chang et al.

GASTROENTEROLOGY (2021)

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Article Gastroenterology & Hepatology

Curative value of underwater endoscopic mucosal resection for submucosally invasive colorectal cancer

Hiromu Fukuda et al.

Summary: This study retrospectively investigated the backgrounds and outcomes of patients with pT1-CRC who underwent UEMR. The findings suggest that UEMR may be feasible for pT1-CRC without characteristics of deep submucosal invasion.

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY (2021)

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Article Gastroenterology & Hepatology

Recurrence rate and lesions characteristics after cold snare polypectomy of high-grade dysplasia and T1 lesions: A multicenter analysis

Naohisa Yoshida et al.

Summary: This study analyzed high-grade dysplasia and T1 lesions resected by cold snare polypectomy (CSP), and found a substantially high local recurrence rate. Positive horizontal margin was identified as a significant risk factor for recurrence, emphasizing the importance of complete resection during CSP.

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY (2021)

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Article Gastroenterology & Hepatology

Pedunculated colorectal polyps with heads ≤ 1 cm in diameter can be resected using cold snare polypectomy

T. Kudo et al.

Summary: This study found that cold snare polypectomy (CSP) is a more efficient method compared to hot snare polypectomy (HSP) for the complete resection of pedunculated colorectal polyps with heads <= 1 cm in diameter, with lower total procedure time and fewer hemostatic clips used. However, CSP is associated with a higher risk of immediate bleeding but a lower risk of delayed bleeding compared to HSP.

ACTA GASTRO-ENTEROLOGICA BELGICA (2021)

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Article Gastroenterology & Hepatology

Does cold snare polypectomy completely resect the mucosal layer? A prospective single-center observational trial

Satoki Shichijo et al.

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY (2020)

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Article Gastroenterology & Hepatology

Endoscopic Removal of Colorectal Lesions: Recommendations by the US Multi-Society Task Force on Colorectal Cancer

Tonya Kaltenbach et al.

AMERICAN JOURNAL OF GASTROENTEROLOGY (2020)

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Article Gastroenterology & Hepatology

Safety and efficacy of cold snare polypectomy for pedunculated (Ip) polyps measuring less than 10 mm in diameter

Jun Arimoto et al.

INTERNATIONAL JOURNAL OF COLORECTAL DISEASE (2020)

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Review Gastroenterology & Hepatology

Rates of Incomplete Resection of 1-to 20-mm Colorectal Polyps: A Systematic Review and Meta-Analysis

Roupen Djinbachian et al.

GASTROENTEROLOGY (2020)

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Article Gastroenterology & Hepatology

Impact of submucosal saline solution injection for cold snare polypectomy of small colorectal polyps: a randomized controlled study

Yuichi Shimodate et al.

GASTROINTESTINAL ENDOSCOPY (2020)

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Article Gastroenterology & Hepatology

Efficacy and safety of three different endoscopic methods in treatment of 6-20 mm colorectal polyps

Dazhou Li et al.

SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY (2020)

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Article Gastroenterology & Hepatology

Dye-based chromoendoscopy following polypectomy reduces incomplete polyp resection

Neil R. O'Morain et al.

ENDOSCOPY INTERNATIONAL OPEN (2020)

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Article Gastroenterology & Hepatology

Local recurrence of diminutive colorectal polyps after cold forceps polypectomy with jumbo forceps followed by magnified narrow-band imaging: a multicenter prospective study

Toshio Kuwai et al.

ENDOSCOPY (2019)

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Article Gastroenterology & Hepatology

Appendix orifice polyps: a study of 691 lesions at a single institution

Tarek H. Hassab et al.

INTERNATIONAL JOURNAL OF COLORECTAL DISEASE (2019)

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Article Multidisciplinary Sciences

Analysis of predictive factors for R0 resection and immediate bleeding of cold snare polypectomy in colonoscopy

Tomonori Aoki et al.

PLOS ONE (2019)

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Article Gastroenterology & Hepatology

Underwater cold snare polypectomy for colorectal adenomas

Daisuke Maruoka et al.

DIGESTIVE ENDOSCOPY (2019)

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Article Gastroenterology & Hepatology

Comparison of Underwater vs Conventional Endoscopic Mucosal Resection of Intermediate-Size Colorectal Polyps

Takeshi Yamashina et al.

GASTROENTEROLOGY (2019)

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Article Medicine, General & Internal

Continuous Anticoagulation and Cold Snare Polypectomy Versus Heparin Bridging and Hot Snare Polypectomy in Patients on Anticoagulants With Subcentimeter Polyps A Randomized Controlled Trial

Yoji Takeuchi et al.

ANNALS OF INTERNAL MEDICINE (2019)

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Review Gastroenterology & Hepatology

Cold snare polypectomy: Indications, devices, techniques, outcomes and future

Akira Horiuchi et al.

DIGESTIVE ENDOSCOPY (2019)

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Review Gastroenterology & Hepatology

Cold snare endoscopic resection of nonpedunculated colorectal polyps larger than 10 mm: a systematic review and pooled-analysis

Viveksandeep Thoguluva Chandrasekar et al.

GASTROINTESTINAL ENDOSCOPY (2019)

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Article Gastroenterology & Hepatology

Wide-field piecemeal cold snare polypectomy of large sessile serrated polyps without a submucosal injection is safe

David J. Tate et al.

ENDOSCOPY (2018)

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Article Gastroenterology & Hepatology

A comparison of the resection rate for cold and hot snare polypectomy for 4-9 mm colorectal polyps: a multicentre randomised controlled trial (CRESCENT study)

Takuji Kawamura et al.

GUT (2018)

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Article Gastroenterology & Hepatology

Challenges associated with the pathological diagnosis of colorectal tumors less than 10mm in size

Shin Ichihara et al.

DIGESTIVE ENDOSCOPY (2018)

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Review Gastroenterology & Hepatology

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

Satoshi Shinozaki et al.

DIGESTIVE ENDOSCOPY (2018)

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Article Gastroenterology & Hepatology

Cold EMR of large sessile serrated polyps at colonoscopy (with video)

Nicholas J. Tutticci et al.

GASTROINTESTINAL ENDOSCOPY (2018)

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Article Gastroenterology & Hepatology

Width and depth of resection for small colorectal polyps: hot versus cold snare polypectomy

Sho Suzuki et al.

GASTROINTESTINAL ENDOSCOPY (2018)

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Article Gastroenterology & Hepatology

Residual adenoma after cold snare polypectomy for small colorectal adenomas: a prospective clinical study

Daisuke Maruoka et al.

ENDOSCOPY (2018)

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Article Gastroenterology & Hepatology

Incomplete resection rate of cold snare polypectomy: a prospective single-arm observational study

Noriko Matsuura et al.

ENDOSCOPY (2017)

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Article Gastroenterology & Hepatology

Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

Monika Ferlitsch et al.

ENDOSCOPY (2017)

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Article Surgery

Endoscopic submucosal dissection for laterally spreading tumors involving the appendiceal orifice

Tomoaki Tashima et al.

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES (2017)

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Article Gastroenterology & Hepatology

Removal of diminutive colorectal polyps: A prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy

Yoriaki Komeda et al.

WORLD JOURNAL OF GASTROENTEROLOGY (2017)

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Article Gastroenterology & Hepatology

Efficacy and safety of cold snare resection in preventive screening colonoscopy

B. Schett et al.

ENDOSCOPY INTERNATIONAL OPEN (2017)

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Article Gastroenterology & Hepatology

Endoscopic Resection of Cecal Polyps Involving the Appendiceal Orifice: A KASID Multicenter Study

Eun Mi Song et al.

DIGESTIVE DISEASES AND SCIENCES (2017)

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Article Gastroenterology & Hepatology

Histological outcomes between hot and cold snare polypectomy for small colorectal polyps

Toshiki Yamamoto et al.

SAUDI JOURNAL OF GASTROENTEROLOGY (2017)

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Article Gastroenterology & Hepatology

Endoscopic submucosal dissection of cecal lesions in proximity to the appendiceal orifice

Harold Jacob et al.

ENDOSCOPY (2016)

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Article Gastroenterology & Hepatology

A prospective randomized comparative study of cold forceps polypectomy by using narrow-band imaging endoscopy versus cold snare polypectomy in patients with diminutive colorectal polyps

Soo-kyung Park et al.

GASTROINTESTINAL ENDOSCOPY (2016)

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Article Gastroenterology & Hepatology

Cold snare polypectomy: Does snare type influence outcomes?

Said Din et al.

DIGESTIVE ENDOSCOPY (2015)

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Article Gastroenterology & Hepatology

Characterization and significance of protrusions in the mucosal defect after cold snare polypectomy

Nicholas Tutticci et al.

GASTROINTESTINAL ENDOSCOPY (2015)

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Article Gastroenterology & Hepatology

Prospective, randomized comparison of 2 methods of cold snare polypectomy for small colorectal polyps

Akira Horiuchi et al.

GASTROINTESTINAL ENDOSCOPY (2015)

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Article Gastroenterology & Hepatology

Feasibility of cold snare polypectomy in Japan: A pilot study

Yoji Takeuchi et al.

WORLD JOURNAL OF GASTROINTESTINAL ENDOSCOPY (2015)

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Article Gastroenterology & Hepatology

Cold snare piecemeal resection of colonic and duodenal polyps 1cm

Neel Choksi et al.

ENDOSCOPY INTERNATIONAL OPEN (2015)

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Article Gastroenterology & Hepatology

Cold polypectomy techniques for diminutive polyps in the colorectum

Toshio Uraoka et al.

DIGESTIVE ENDOSCOPY (2014)

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Article Gastroenterology & Hepatology

Removal of small colorectal polyps in anticoagulated patients: a prospective randomized comparison of cold snare and conventional polypectomy

Akira Horiuchi et al.

GASTROINTESTINAL ENDOSCOPY (2014)

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Article Gastroenterology & Hepatology

Cold Snare Polypectomy Vs. Cold Forceps Polypectomy Using Double-Biopsy Technique for Removal of Diminutive Colorectal Polyps: A Prospective Randomized Study

Chang Kyun Lee et al.

AMERICAN JOURNAL OF GASTROENTEROLOGY (2013)

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Article Gastroenterology & Hepatology

Safety of cold polypectomy for < 10 mm polyps at colonoscopy: a prospective multicenter study

A. Repici et al.

ENDOSCOPY (2012)

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Article Gastroenterology & Hepatology

Prospective Randomized Comparison of Cold Snare Polypectomy and Conventional Polypectomy for Small Colorectal Polyps

Yasuyuki Ichise et al.

DIGESTION (2011)

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Article Gastroenterology & Hepatology

Colon polyp retrieval after cold snaring

VP Deenadayalu et al.

GASTROINTESTINAL ENDOSCOPY (2005)

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Colorectal cold snare polypectomy: Current standard technique and future perspectives

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