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Background/aims: Cold snare polypectomy (CSP) is routinely performed for small colorectal polyps (≤10 mm). However, challenges include insufficient resection depth and immediate bleeding, hindering precise pathological evaluation. We aimed to compare the outcomes of cold endoscopic mucosal resection (CEMR) with that of CSP for colorectal polyps ≤10 mm, using data from randomized controlled trials (RCTs).
Methods: Multiple databases were searched in December 2023 for RCTs reporting outcomes of CSP versus CEMR for colorectal polyps ≤10 mm in size. Our primary outcomes were rates of complete and en-bloc resections, while our secondary outcomes were total resection time (seconds) and adverse events, including immediate bleeding, delayed bleeding, and perforation.
Results: The complete resection rates did not significantly differ (CSP, 91.8% vs. CEMR 94.6%), nor did the rates of en-bloc resection (CSP, 98.9% vs. CEMR, 98.3%) or incomplete resection (CSP, 6.7% vs. CEMR, 4.8%). Adverse event rates were similarly insignificant in variance. However, CEMR had a notably longer mean resection time (133.51 vs. 91.30 seconds).
Conclusions: Our meta-analysis of seven RCTs showed that while both CSP and CEMR are equally safe and effective for resecting small (≤10 mm) colorectal polyps, the latter is associated with a longer resection time.
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http://dx.doi.org/10.5946/ce.2024.081 | DOI Listing |
Lancet Gastroenterol Hepatol
October 2025
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.
Background: Guidelines recommend leaving in situ rectosigmoid polyps diagnosed during colonoscopy that are 5 mm or smaller if the endoscopist optically predicts them to be non-neoplastic. However, no randomised controlled trial has been done to examine the efficacy and safety of this strategy.
Methods: This open-label, multicentre, non-inferiority, randomised controlled trial enrolled adults age 18 years or older undergoing colonoscopy for screening, surveillance, or clinical indications across four Italian centres.
Gastrointest Endosc
September 2025
Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Medicine, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH; NH Colonoscopy Registry, Lebanon, NH.
Background And Aims: Data comparing the location of polyp yield in patients with positive stool tests can aid screening test selection. We conducted a cross sectional analysis of New Hampshire Colonoscopy Registry data to compare the location, left versus right side of the colon, of neoplasia detected on colonoscopy following a mt-sDNA+ or FIT+ test as compared to a reference group having colonoscopy without a stool test.
Methods: Our outcomes were advanced lesions (adenoma and/or serrated polyp, including cancer), advanced adenomas (AA), or advanced serrated polyps (ASP), stratified by location.
Fam Cancer
September 2025
Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Avenue / A30, Cleveland, OH, 44195, USA.
Familial adenomatous polyposis (FAP) is an inherited condition that predisposes individuals to colorectal cancer without preventive treatment. Surgical management typically involves restorative proctocolectomy with an ileal pouch anal anastomosis or colectomy with ileorectal anastomosis. Complete removal of the large intestine and rectum with a permanent stoma may also be required in selected cases.
View Article and Find Full Text PDFFam Cancer
September 2025
Ambry Genetics, 1 Enterprise, Aliso Viejo, CA, 92656, USA.
Pathogenic variants in the APC gene are classically associated with autosomal dominant familial adenomatous polyposis (FAP), characterized by tens-to-thousands of colonic adenomatous polyps and a high-penetrance predisposition to colorectal cancer. More recently, specific PVs in the YY1 binding motif of APC promoter 1B have been associated with autosomal dominant gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS), characterized by tens-to-thousands of fundic gland polyps and a predisposition to gastric cancer but which are only rarely associated with features consistent with FAP. Although management guidelines currently treat FAP and GAPPS as mutually exclusive conditions, the extent of phenotypic overlap is not well-characterized.
View Article and Find Full Text PDFIET Syst Biol
September 2025
School of Computer and Information Techonology, Xinyang Normal University, Xinyang, China.
Accurate polyp segmentation is crucial for computer-aided diagnosis and early detection of colorectal cancer. Whereas feature pyramid network (FPN) and its variants are widely used in polyp segmentation, inherent limitations existing in FPN include: (1) repeated upsampling degrades fine details, reducing small polyp segmentation accuracy and (2) naive feature fusion (e.g.
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