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The following is a summary of “Efficacy and Safety of Cold Versus Hot Snare Endoscopic Mucosal Resection in Colorectal Polyp Removal: A Systematic Review and Meta-Analysis,” published in the January 2025 issue of Gastroenterology by Niu et al.
Cold snare endoscopic mucosal resection (C-EMR) offers a safety advantage over hot snare endoscopic mucosal resection (H-EMR) for managing colorectal lesions.
Researchers conducted a retrospective study evaluating the safety and effectiveness of cold vs. hot snare EMR in people with colorectal polyps.
They performed a meta-analysis to compare outcomes between people undergoing C-EMR and those undergoing H-EMR, calculating pooled odds ratios (ORs) for various outcomes.
The results showed that the pooled OR for complete resection rates was 0.70 (95% CI: 0.36-1.36, P=0.29), and for en bloc resection rates, was 0.24 (95% CI: 0.05-1.08, P=0.06) between the C-EMR and H-EMR groups. The overall complete resection rate for C-EMR was 84%, with an en-bloc resection rate of 57%. C-EMR was associated with a lower incidence of delayed bleeding. Polyps recurred in 2% of people with sessile serrated polyps (SSP) and 23% of those with non-SSP lesions. Subgroup analysis showed minimal recurrence in lesions between 10 to 20 mm and ≥20 mm when treated with C-EMR.
They concluded that people with colorectal lesions could benefit from C-EMR as a safer and equally effective alternative to H-EMR.
Source: journals.lww.com/jcge/abstract/2025/01000/efficacy_and_safety_of_cold_versus_hot_snare.3.aspx
