Cold versus hot snare polypectomy in treatment of small colorectal polyps: a retrospective study on safety and efficacy

Abstract

Objective To evaluate the safety and efficacy of cold snare polypectomy (CSP) and hot snare polypectomy (HSP) in the treatment of small colorectal polyps. Methods The clinical data of 3 750 patients who underwent endoscopic polypectomy for small colorectal polyps in our hospital from January 1, 2020 to August 31, 2021 were collected and analyzed retrospectively. There were 1 796 cases assigned into CSP group and 1 954 cases into HSP group. Their general data, number and utilization rate of titanium clips, complete resection rate, specimen recovery rate, incidence of delayed bleeding, perforation rate and incidence of abdominal discomfort were analyzed and compared between the 2 groups. Results There were no significant differences in the general data (age, gender, BMI, and number, size, location, morphology and pathological type of polyps) and in proportions of comorbidities (hypertension and diabetes) between the 2 groups (P>0.05). The utilization rate and average number of clips used were significantly lower in the CSP group than the HSP group (11.19% vs 19.55%, P < 0.001; 0.16±0.49 vs 0.27±0.63, P < 0.001). No statistical difference was found in the complete resection rate between the 2 groups (93.99% vs 95.04%, P=0.158). The CSP group had higher specimen recovery rate (99.55% vs 98.26%, P < 0.001), lower incidence of delayed bleeding (0.06% vs 0.46%, P=0.037) and incidence of abdominal discomfort (4.18% vs 9.31%, P < 0.001) when compared with the HSP group. In terms of perforation, no occurrence was observed in the CSP group and 1 case (0.05%) in the HSP group, though no statistical difference (P=0.521). Conclusion When compared with HSP, CSP has advantages of lower utilization rate and less number of titanium clips, higher specimen recovery rate, and lower incidence of complications in the treatment of small colorectal polyps. It is a safe and effective treatment, and worthy of clinical application.

Keywords

• colorectal polyp
• cold polypectomy
• hot polypectomy
• complications