Proving What We All Know: Hot Snare Polypectomy Causes More Delayed Bleeding Than Cold Snare
Douglas K. Rex, MD, MASGE, reviewing Takamaru H, et al. Gastrointest Endosc 2021 Dec 28.
This was a retrospective analysis of bleeding after cold snare polypectomy (CSP) and hot snare polypectomy (HSP) for colorectal lesions with a diameter <10 mm. CSP or HSP was used at the endoscopist’s discretion over a 4-year period.
In 12,928 lesions removed by CSP and 2408 by HSP in 5371 total patients, the risk of bleeding was 0.1 after CSP and 0.54 after HSP. After propensity score matching for patient age, lesion size, macroscopic feature, location, antithrombotic use, and clip use, the prevalence of postpolypectomy bleeding was higher after HSP than CSP (odds ratio, 6.0; 95% confidence interval, 1.34-26.8).
COMMENTThis is not the first retrospective study to demonstrate a reduced risk of bleeding with CSP, but it’s important that evidence continue to accumulate. It is hard to show these differences in randomized controlled trials, which are typically powered for completeness of resection rather than demonstration of differences in risk.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Takamaru H, Saito Y, Hammoud GM, et al. Comparison of postpolypectomy bleeding events between cold snare polypectomy and hot snare polypectomy for small colorectal lesions: a large-scale propensity score-matched analysis. Gastrointest Endosc 2021 Dec 28. (Epub ahead of print) (https://doi.org/10.1016/j.gie.2021.12.017)
