Does the size of the cold snare affect the outcome of cold snare polypectomy in the colon? A KASID prospective multicenter study

Intestinal Research · Published 2026-01-29 · DOI 10.5217/ir.2025.00189

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Abstract

Background/Aims Cold snare polypectomy (CSP) is recommended for colorectal polyps <10 mm; however, the impact of snare size on clinical outcomes remains unclear. This study evaluated the efficacy and safety of 10-mm and 15-mm snares for CSP of small colorectal polyps. Methods In this prospective multicenter study, patients with 4–10 mm non-pedunculated polyps underwent CSP with either a 10-mm or 15-mm snare. Both snares had identical wire thickness and hexagonal loop design. The primary outcome was histological complete resection rate (CRR). Secondary outcomes included adverse events and technical parameters. Results In total, 182 patients were enrolled (10-mm group: n = 92; 15-mm group: n = 90). Baseline characteristics, including age, sex, polyp size, morphology, location, and pathology, were comparable between groups. Histological CRRs were 90.2% in the 10-mm group and 91.1% in the 15-mm group (P= 0.483). No significant differences were observed in the presence of submucosal tissue within specimens (P= 0.523), iatrogenic ulcer size (P= 0.532), hematoma occurrence (P= 0.391), or intraprocedural bleeding requiring hemostasis (6.5% vs. 5.6%; P= 0.974). No cases of delayed bleeding or perforation were reported. Logistic regression analysis identified iatrogenic ulcer size > 8 mm as an independent predictor of complete resection (odds ratio, 3.89; 95% confidence interval, 1.15–13.21; P= 0.029); snare size was not significantly associated with CRR (P= 0.519). Conclusions CSP using either a 10-mm or a 15-mm snare for 4–10 mm non-pedunculated colorectal polyps showed no significant difference in complete resection or safety outcomes within this size range. (Clinical Research Information Service [CRIS], KCT0005031)

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Publication details

Year
2026

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