Efficacy and safety of cold snare and hot snare endoscopic mucosal resection in the removal of colorectal polyps: a systematic review and meta-analysis based on RCT studies.
Scand J GastroenterolJul 23, 2026 (epub)
Clinical ResearchGastroenterology
Yihang Liu, Yuqing Lu, Kejia Liu et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy and safety of cold snare endoscopic mucosal resection (C-EMR) versus hot snare endoscopic mucosal resection (H-EMR) for colorectal polyps in 1466 patients across eight randomized controlled trials. C-EMR was found to significantly shorten procedural time for polyps ≤20 mm, while H-EMR was faster for polyps >20 mm. C-EMR also demonstrated lower risks of perforation and delayed bleeding.
Key findings
- C-EMR significantly shortened procedural time for polyps ≤20 mm (MD = -11.53 min, p = 0.004).
- H-EMR was faster for polyps >20 mm (MD = 3.89 min, p < 0.001).
- C-EMR had significantly lower risks of perforation (RR = 0.11, p = 0.01) and delayed bleeding (RR = 0.46, p = 0.02).
- C-EMR showed a trend toward higher postoperative recurrence in polyps >20 mm (p = 0.08).
Why it matters
Understanding the comparative efficacy and safety of C-EMR and H-EMR can guide clinicians in selecting the appropriate technique for colorectal polyp removal, potentially improving patient outcomes and minimizing complications.