Diminutive colorectal polyp resection comparing hot and cold snare and cold biopsy forceps polypectomy. Results of a pilot randomized, single-center study (with videos)1

Colonoscopy is one of the most commonly performed endoscopic procedures, and it has played a pivotal role in the detection and prevention of colorectal cancer (CRC). Small (6–9mm) and diminutive (1–5mm) colorectal polyps account for a large proportion of lesions found during colonoscopy. Recent evidence suggests that colonoscopy may be less effective at CRC prevention than previously thought [1,2]. Potential reasons for the gap in CRC prevention include failure to detect polyps, rapidly growing polyps, and incomplete polyp removal [3]. Despite their widespread use, little is known about the best methods of polypectomy in terms of optimizing completeness of removal. Many techniques are now available for polypectomy, including hot snare, cold snare, and cold biopsy forceps (including jumbo forceps). Guidelines on the standard of care for management of diminutive polyps are lacking. Several prospective studies have evaluated the completeness of polypectomy on diminutive lesions and have compared several techniques; however, these studies 1 Contributorship: conception and design, V. G., R. J. B., J. E. C., M. K., N. N. D., M. B. W.; analysis and interpretation of data, V. G., J. E. C., M. K., N. N. D., M. B. W.; drafting of the article and revising it critically for important intellectual content, V. G., R. J. B., J. E. C., M. B.W.; final approval of the version to be published, V. G., R. J. B., J. E. C., M. K., N. N. D., M. B. W. Funding sources: funded by a grant from Boston Scientific Corporation, Natick, MA, USA. It has not been previously presented. Manuscript was presented as a poster at Digestive Disease Week, 6 May 2014; Chicago, IL, USA.