This was a non-inferiority randomized controlled trial designed to compare the efficacy and safety of cold versus hot snare polypectomy for the removal of 4-10 mm pedunculated colorectal polyps. The primary outcome was delayed postpolypectomy bleeding. The secondary outcomes included immediate postpolypectomy bleeding, procedure time, en bloc resection, complete histologic resection, use of haemostatic clips and perforation rate.
18-80 years old, male and female
Proposed colonoscopy and colonoscopy detection of at least one 4-10 mm pedunculated colorectal polyp
Contraindication to colonoscopy or polypectomy
Use of antiplatelet or anticoagulant drugs within 1 week before polypectomy
Alarming signs and symptoms of colorectal cancer (blood in stool, black stool, unexplained anaemia and weight loss, abdominal mass, positive rectal examination; or imaging and laboratory tests highly suspicious for colorectal cancer) or endoscopic manifestations of polyps highly suspicious for high-grade intraepithelial neoplasia or carcinoma
Comorbidity with inflammatory bowel disease, colonic polyposis, or active gastrointestinal bleeding
Parallel
cold snare polypectomy
Procedure/SurgeryCold snare polypectomy was conducted for the removal of 4-10 mm pedunculated colorectal polyps.
hot snare polypectomy
Procedure/SurgeryHot snare polypectomy was conducted for the removal of 4-10 mm pedunculated colorectal polyps.
delayed postoperative bleeding
bleeding that developed within 2 weeks after the patient left the endoscopy unit
immediate postpolypectomy bleeding
Blood spray or persistent oozing for more than 60 seconds requiring endoscopic intervention
procedure time
The duration from the appearance of the snare on the monitor to the time when the endoscope was withdrawn from the lesion
en bloc resection
Removal of a polyp with a single cut and was assessed by the colonoscopist
complete histologic resection
Clear resection margins, no polyp involvement
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