Chaptini LA, Jalloul S, Karam K. Cold snare polypectomy: A closer look at the efficacy and limitations for polyps 10-20 mm in size. World J Gastrointest Endosc 2024; 16(8): 445-450 [DOI: 10.4253/wjge.v16.i8.445]
Corresponding Author of This Article
Louis A Chaptini, MD, Assistant Professor, Department of Medicine, Digestive Diseases, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States. louis.chaptini@yale.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Aug 16, 2024; 16(8): 445-450 Published online Aug 16, 2024. doi: 10.4253/wjge.v16.i8.445
Cold snare polypectomy: A closer look at the efficacy and limitations for polyps 10-20 mm in size
Louis A Chaptini, Sarah Jalloul, Karam Karam
Louis A Chaptini, Department of Medicine, Digestive Diseases, Yale School of Medicine, New Haven, CT 06510, United States
Louis A Chaptini, Sarah Jalloul, Karam Karam, Department of Medicine, Gastroenterology, University of Balamand, Balamand 100, Lebanon
Author contributions: Chaptini LA conceived the original idea, designed the editorial framework, reviewed the literature, and wrote the final version; Jalloul S and Karam K gathered data and reviewed literature used in the editorial.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Louis A Chaptini, MD, Assistant Professor, Department of Medicine, Digestive Diseases, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510, United States. louis.chaptini@yale.edu
Received: May 26, 2024 Revised: June 29, 2024 Accepted: July 29, 2024 Published online: August 16, 2024 Processing time: 67 Days and 9.7 Hours
Abstract
Current guidelines recommend cold snare polypectomy for polyps less than 10 mm in size. Conversely, endoscopic mucosal resection is still the preferred technique for larger polyps. Concerns regarding cold snare polypectomy for larger polyps revolve around the difficulty in conducting en-bloc resection (resulting in piecemeal removal), and the potential for local residual polyp tissue and a high rate of recurrence. On the other hand, cold snare technique has the advantages of shortening procedure time, reducing delayed bleeding risks and lowering cost of treatment. Numerous ongoing and recent studies are focused on evaluating the risks and benefits of this technique for polyps larger than 10 mm, with the goal of providing clear guidelines in the near future. The aim of this editorial is to provide our readers with an overview regarding this subject and the latest developments surrounding it.
Core Tip: Guidelines recommend using cold snare polypectomy for polyps under 10 mm, while endoscopic mucosal resection is still favored for larger ones. Concerns about cold snare technique for bigger polyps include difficulties in complete resection and higher recurrence rates. However, it offers shorter procedure times, less bleeding risk, and lower costs. Ongoing studies aim to clarify its effectiveness for larger polyps, with updated guidelines expected in the future.
