ASGE Postgraduate Course at ACG 2022: Expanding the Scope of Fundamental and Advanced Endoscopy | October 2022-Point Counterpoint: Cold Snare Polypectomy for Polyps Large and Small

Point Counterpoint: Cold Snare Polypectomy for Polyps Large and Small

Video Transcription

Video Summary

In this video, Professor Charles Kahi from Indiana University presents a counterpoint on cold-snare polypectomy for polyps of various sizes. He begins by highlighting the historical lack of objective data and reliance on subjective preferences in polypectomy techniques. However, he mentions that the "cold revolution" has led to a shift in favor of cold-snare polypectomy. He emphasizes that this technique is effective and safe, with low rates of incomplete resection and no risk of delayed bleeding or perforation. Comparisons with other polypectomy methods, such as cold forceps and hot-snare polypectomy, consistently show the superiority of cold-snare polypectomy in terms of complete eradication rates, safety, and reduced risk of adverse events. The field of cold-snare polypectomy is evolving, with recent studies supporting its use for larger polyps. However, there are certain caveats to consider, such as difficulties in transecting larger polyps in one go and the need for submucosal injection in some cases. Overall, cold-snare polypectomy is recommended for small and diminutive polyps and shows potential for larger polyps and serrated lesions. The technique meets the requirements for high-quality colonoscopy.

Asset Subtitle

Charles J. Kahi, MD, MSc, FASGE, FACG

Keywords

cold-snare polypectomy

polyps

technique

complete eradication rates

safety