Cold Snare Resection in the Colorectum: When to Choose it, When to Avoid it, and How to Do it

John J Guardiola; Joseph C Anderson; Tonya Kaltenbach; Heiko Pohl; Douglas K Rex

doi:10.1016/j.cgh.2024.08.030

Cold Snare Resection in the Colorectum: When to Choose it, When to Avoid it, and How to Do it

Clin Gastroenterol Hepatol. 2024 Sep 23:S1542-3565(24)00830-9. doi: 10.1016/j.cgh.2024.08.030. Online ahead of print.

Authors

John J Guardiola¹, Joseph C Anderson², Tonya Kaltenbach³, Heiko Pohl², Douglas K Rex⁴

Affiliations

¹ Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: [email protected].
² Section of Gastroenterology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; White River Junction VA Medical Center, White River Junction, Vermont.
³ Division of Gastroenterology, University of California San Francisco, San Francisco, California; San Francisco VA Medical Center, San Francisco, California.
⁴ Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana.

PMID: 39321950
DOI: 10.1016/j.cgh.2024.08.030

Abstract

Cold snaring is now the preferred resection method for the majority of colorectal polyps encountered during colonoscopy. A key advantage of cold resection over resection utilizing electrocautery is a substantially lower risk of delayed hemorrhage. Cold snare resection is preferred for all lesions ≤10 mm and for nondysplastic sessile serrated lesions of any size but should be avoided when lesions have a significant risk of submucosal invasion or fibrosis. Cold snare resection can be considered for certain lesions 11-19 mm in size and some lateral spreading lesions ≥20 mm. This review discusses tips and techniques to optimize cold snare resection.

Keywords: Cold Snare Resection; Colon Polyps; Colonoscopy; Rectal Polyps.

Publication types

Review