Objective To explore endoscopic mucosal resection using cold snare (CS-EMR) versus hot snare (HS-EMR) for 6-10 mm sessile colorectal polyps.

Methods From January, 2016 to June, 2017, 110 patients who were treated in Jiangyin Hospital of traditional Chinese medicine with 131 polyps were consecutively included and randomly assigned to two groups: CS-EMR and HS-EMR groups. Submucosal injection with normal saline mixed with methylene blue was performed in both groups. To analyze the rate of complete resection, procedure time, adverse events including intraoperative bleeding or perforation, postoperative bleeding within one month, as well as the incidence of polyp residue or recurrence within six months.

Results CS-EMR group included 55 patients with 62 polyps and HS-EMR group included 55 patients with 69 polyps. There was no significant difference in the size, location, morphology, or pathology of the polyps. The rates of complete resection in CS-EMR and HS-EMR were 95.2% and 91.3%, respectively (P=0.60). The operation time of the CS-EMR group was shorter than that of the HS-EMR group (2.2±1.1min vs3.6±1.4 min, P < 0.01). In the CS-EMR group, there was 1 case of intraoperative bleeding and 1 case of delayed bleeding; in HS-EMR group, there were 2 cases of intraoperative bleeding, 1 case of intraoperative perforation, and 1 case of delayed bleeding. There was no difference in the adverse event rate (P=0.68). Repeat colonoscopy in 6 months showed no polyp residual or recurrence.

Conclusion CS-EMR appears to be a valuable modification of the standard cold snare technique for the treatment of 6-10 mm sessile colorectal polyps.