Cold snare endoscopic mucosal resection may delay bleeding and perforation for treating colorectal polyps: Study

However, the cold EMR method showed a higher rate of recurrent or residual neoplasia. The patients undergoing cold EMR were twice as likely to experience neoplasia recurrence when compared to the ones treated with hot EMR, with an RR of 2.03 (95% CI: 1.19–3.48). This highlights a trade-off in its use, as recurrence could necessitate additional interventions.

The study found no significant differences between cold and hot EMR in outcomes such as en bloc resection or incomplete resection which indicated similar efficacy in achieving complete removal of targeted polyps during the initial procedure.

The findings offer valuable insights for clinicians choosing between cold and hot EMR techniques. While cold EMR offers a safer profile with respect to bleeding and perforation, its higher recurrence risk necessitates careful patient selection and possibly improved surveillance post-procedure. As interest in non-thermal methods like cold EMR grows, these results illuminate the importance of weighing individual patient factors and clinical priorities. 

Source:

Saeed, A., Yousuf, S., Noverati, N., Chen, A., Saleem, N., Farooq, U., Muniraj, T., Persaud, A., Xiao, Y., Kumar, A., Schlachterman, A., Kowalski, T., Adler, D., & Kamal, F. (2024). Cold versus hot snare endoscopic mucosal resection of colorectal polyps: meta-analysis of randomized controlled trials. In Gastrointestinal Endoscopy. Elsevier BV. https://doi.org/10.1016/j.gie.2024.12.032