| Theme | Cold polypectomy : Merits and demerits | |
|---|---|---|
| Title | Review on cold polypectomy techniques for small and diminutive colorectal polyps | |
| Publish Date | 2016/09 | |
| Author | Wataru Sano | Gastrointestinal Center, Sano Hospital |
| Author | Yasushi Sano | Gastrointestinal Center, Sano Hospital |
| [ Summary ] | Approximately 90 % of colorectal polyps encountered during colonoscopy are <10 mm, 90 % of which are diminutive (≤5 mm). Although the risk of advanced neoplasia in diminutive polyps is extremely low, the safe and effective resection of these lesions is crucial to reduce the incidence and mortality of colorectal cancers. Many randomized controlled studies comparing cold biopsy forceps or snare polypectomy without cautery and hot biopsy forceps or snare polypectomy with cautery for small (6-9 mm) and diminutive polyps have been conducted to evaluate their safety and efficacy. These investigations have indicated that cold polypectomy is safer than hot polypectomy, with an almost equal efficacy. Therefore, cold polypectomy techniques have recently been preferred over hot polypectomy in Western countries. Over the last decade, hot biopsy forceps polypectomy has been gradually abandoned because of its increased risk of diathermic injury. In terms of complete resection, cold biopsy forceps and snare polypectomies are two possible alternatives for polyps ≤3 mm, whereas cold snare polypectomy should be used for larger lesions. Cold polypectomy techniques are now attracting increasing attention in Japan as well. In the next decade, cold polypectomy may play a central role in the resection of colorectal polyps <10 mm. |
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