To lower the incidence and death rate of colorectal cancer, cold snare polypectomy (CSP), one of the endoscopic resection procedures, has been advised for the removal of small polyps (5 mm) or noncancerous polyps up to 10 mm in size.[1] CSP has advanced somewhat recently. The indications, effectiveness, safety, and development of CSP are covered in this publication.
The European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline suggests CSP as the preferred method for the excision of small polyps (5 mm), as it achieves a high rate of complete resection, low rates of complications, and permits adequate tissue sampling for histology (High-quality evidence, strong recommendation).[1] The outcomes of numerous randomized, single-center trials on tiny polyps (10 mm) have demonstrated that CSP can meet the criteria for histological eradication, safety, and promptness.[2,3] Due to its higher safety profile, ESGE also advises using CSP for sessile serrated polyps (SSPs) that are 6 to 9 mm in size (Moderate quality evidence, weak recommendation).
For polyps smaller than 10 mm in size, several studies have been done to assess the results of cold snare resection.[4] The findings showed that utilizing CSP had a 99.3% full removal rate, which meant that the probability of adverse outcomes was not increased. The percentage of remaining polyps (4.1%) and the recurrence rate (12.2-13.8%) were both acceptable, according to follow-up colonoscopies. Nonpedunculated Large Colon Polyps have also recently been treated with Wide-field Piecemeal CSP. The results of certain research have shown that CSP is a safe and successful procedure for resecting colorectal polyps larger than 10 mm, despite the fact that the data for its effectiveness in eliminating large polyps is currently sparse.
