A prospective randomized comparison of cold vs hot snare polypectomy in the occurrence of postpolypectomy bleeding in small colonic polyps.

Aim  Polypectomy techniques in the removal of polyps in the 3–8 mm size range are inconsistent. The aim of our study was to compare cold (CSP) with hot snare polypectomy (HSP) in the occurrence of postpolypectomy bleeding in small colonic polyps 3–8 mm in size. Method  In all, 414 consecutive patients with small colorectal polyps 3–8 mm in size were prospectively randomized into the CSP group and the HSP group. Results  There was no early or late postpolypectomy bleeding in either group. Intraprocedural bleeding was significantly more frequent in the CSP group than the HSP group (CSP, 19/208; HSP, 2/206; P < 0.001) but resolved spontaneously without any intervention in both groups. Conclusion  The data show that the CSP technique is safe, effective and quicker than HSP for patients and it could be considered the ideal procedure for small polyp removal.