Clinical analysis of cold vs hot snare polypectomy for 10-19 mm non-pedunculated colorectal polyps.

BACKGROUND: Cold snare polypectomy (CSP) is comparatively safe and effective for removing polyps less than 10 mm in size with lower rates of postpolypectomy syndrome and delayed postpolypectomy bleeding compared with hot snare polypectomy (HSP). Recently, CSP is also expanded for removing polyps larger than 10 mm in size. AIM: To compare the efficiency and safety of CSP and HSP in the management of 10-19 mm non-pedunculated colorectal polyps. METHODS: A total of 1686 inpatients with at least one 10-19 mm non-pedunculated colorectal polyp, who underwent CSP (study group, n = 843) or HSP (control group, n = 843) at our Digestive Endoscopy Center between February 2020 and February 2024 were enrolled. The outcome measures including complete resection rate, intraoperative bleeding rate, and healthcare expenses such as procedure time and treatment cost were compared between the CSP vs HSP groups. RESULTS: No statistically significant intergroup difference was observed in histological complete resection rates (P > 0.05). Polyp resection time in the study group (76.5 ± 23.6 seconds) was notably shorter than that in the control group (91.24 ± 32.06 seconds; P < 0.05). The immediate intraoperative bleeding rate was significantly higher in the study group than in the control group (12.7% vs 4.9%, P < 0.05). No instances of delayed bleeding or perforation were documented in either group. Hospitalization duration was significantly reduced in the study group (2.42 ± 0.61 days) compared to the control group (3.21 ± 1.02 days; P < 0.05). CONCLUSION: For 10-19 mm non-pedunculated colorectal polyps, CSP demonstrates operational efficiency advantages over HSP in terms of procedure time, treatment cost, and length of hospital stay. Both techniques demonstrate robust safety profiles; however, CSP is associated with a higher intraoperative bleeding rate. Clinical decision-making should incorporate individualized assessment of these factors.