GASTROENTEROLOGY ARTICLE OF THE WEEK
April 7, 2011
Hewett DG, Rex DK. Colonoscopy and diminutive polyps: Hot or Cold biopsy or Snare? Do I send to pathology? Clin Gastroenterol Hepatol 2011;9:102-105.
1. When performing cold snares of small polyps
a. Only the polyp should be removed, taking care to avoid the surrounding normal mucosa
b. Once the polyp is snared, it should be tented prior to closing the snare
c. The colon should be partially deflated prior to snaring the polyp
d. The polyp does not need to be retrieved
True or False
2. Recurrence rates of up to 30% have been documented when small polyps are removed using biopsy forceps (cold or hot)
3. Cold snare polypectomy of small polyps is safe even in anticoagulated patients
4. There is firm evidence that cold snare leaves behind less polyp tissue than biopsy forceps
5. The majority of polyps <5mm have a significant risk of eventually evolving into colorectal cancer
6. Hot biopsy forceps polypectomy is ideal for small polyps on the left colon
7. A patient with multiple diminutive pearly white polyps in the rectum should undergo removal of every polyp using cold snare polypectomy