Cold resection for colorectal polyps: where we are and where we are going?

Expert Rev Gastroenterol Hepatol. 2023 Jul-Dec;17(7):719-730. doi: 10.1080/17474124.2023.2223976. Epub 2023 Jun 15.

Abstract

Introduction: Endoscopic resection of colonic precancerous lesions has been demonstrated to significantly decrease colorectal cancer (CRC) incidence and mortality. Among resection techniques, cold snare polypectomy (CSP) has been shown as a highly feasible, effective and safe option and is widely used in clinical practice, being regarded as the first-line technique for removal of small and diminutive colorectal polyps. On the other hand, conventional hot snare polypectomy (HSP) and endoscopic mucosal resection (EMR), namely the gold standard treatments for larger polyps, may be occasionally associated to complications due to electrocautery injury.

Areas covered: To overcome these shortcomings of electrocautery-based resection techniques, in the last few years CSP has been increasingly assessed as a treatment option for additional indications, with a focus on nonpedunculated colorectal polyps ≥10 mm.

Expert opinion: This review aims to present current and widened indications of CSP discussing the latest findings from the most remarkable studies, with an insight into technical issues, novelties and potential advances in the near future.

Keywords: Cold snare resection; EMR; colon cancer; colorectal polyps; therapeutic endoscopy.

Publication types

  • Review

MeSH terms

  • Colonic Polyps* / pathology
  • Colonic Polyps* / surgery
  • Colonoscopy / adverse effects
  • Colonoscopy / methods
  • Colorectal Neoplasms* / pathology
  • Colorectal Neoplasms* / surgery
  • Endoscopic Mucosal Resection* / adverse effects
  • Endoscopic Mucosal Resection* / methods
  • Humans
  • Microsurgery / methods