{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:45:48Z","timestamp":1791866748658,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2027,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Small colorectal polyps sometimes include high\u2010grade adenomas or carcinomas that require endoscopic resection with electrocautery. Recent studies have reported the usefulness of low\u2010power pure\u2010cut hot snare polypectomy (LPPC\u2010HSP) as a less invasive technique. However, the actual resection depth of LPPC\u2010HSP has not been fully investigated. Therefore, this study aimed to evaluate the resection ability of LPPC\u2010HSP for small colorectal polyps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single\u2010arm prospective observational study, patients scheduled to undergo LPPC\u2010HSP for nonpedunculated colorectal polyps smaller than 10\u00a0mm were enrolled. The primary outcome was the rate of sufficient vertical R0 resection (SVR0), defined as an R0 resection with a sufficient submucosal layer beneath the whole lesion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 95 patients with 150 lesions were included. The en bloc and R0 resection rates were 100% and 83%, respectively. The SVR0 rate was 76.7% (90% confidence interval: 70.3%\u201382.2%). All specimens contained the muscularis mucosa, and 132 lesions (88%) contained submucosal tissue. The median maximum submucosal thickness was 1331 \u00b5m (interquartile range, 736\u20132044 \u00b5m). No bleeding, perforation, or other serious adverse events were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LPPC\u2010HSP demonstrated acceptable vertical resection capability. LPPC\u2010HSP may be applicable for colorectal polyps smaller than 10\u00a0mm with potential malignancy, providing resection depth comparable to that of conventional electrocautery\u2010based methods.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration<\/jats:bold>\n                      : University Hospital Medical Network Clinical Trials Registry: UMIN000054732\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/deo2.70450","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:56:23Z","timestamp":1791863783000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Resection Ability of Low\u2010power Pure\u2010cut Hot Snare Polypectomy for Nonpedunculated Colorectal Polyps Smaller Than 10 mm: A Single\u2010center Prospective Study"],"prefix":"10.1002","volume":"7","author":[{"given":"Ryo","family":"Mizuno","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Gastroenterology Shiga University of Medical Science  Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenori","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Digestive Endoscopy Shiga University of Medical Science  Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoji","family":"Kushima","sequence":"additional","affiliation":[{"name":"Department of Pathology Shiga University of Medical Science  Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akifumi","family":"Notsu","sequence":"additional","affiliation":[{"name":"Clinical Research Center Shizuoka Cancer Center  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Nishida","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology Shiga University of Medical Science  Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Inatomi","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology Shiga University of Medical Science  Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuji","family":"Iwashita","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology Shiga University of Medical Science  Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"issue":"27","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1056\/NEJM199312303292701","article-title":"Prevention of Colorectal Cancer by Colonoscopic Polypectomy","volume":"329","author":"Winawer S. J.","year":"1993","journal-title":"New England Journal of Medicine"},{"issue":"8","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1056\/NEJMoa1100370","article-title":"Colonoscopic Polypectomy and Long\u2010Term Prevention of Colorectal\u2010Cancer Deaths","volume":"366","author":"Zauber A. G.","year":"2012","journal-title":"New England Journal of Medicine"},{"issue":"10","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1055\/s-0042-108727","article-title":"Terminal Digit Preference Biases Polyp Size Measurements at Endoscopy, Computed Tomographic Colonography, and Histopathology","volume":"48","author":"Plumb A. A.","year":"2016","journal-title":"Endoscopy"},{"issue":"7","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1055\/a-2304-3219","article-title":"Colorectal Polypectomy and Endoscopic Mucosal Resection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline\u2014Update 2024","volume":"56","author":"Ferlitsch M.","year":"2024","journal-title":"Endoscopy"},{"issue":"11","key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"1950","DOI":"10.1136\/gutjnl-2017-314215","article-title":"A Comparison of the Resection Rate for Cold and Hot Snare Polypectomy for 4\u20139 Mm Colorectal Polyps: A Multicentre Randomised Controlled Trial (CRESCENT study)","volume":"67","author":"Kawamura T.","year":"2018","journal-title":"Gut"},{"issue":"3","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"311","DOI":"10.7326\/M22-2189","article-title":"Cold versus Hot Snare Polypectomy for Small Colorectal Polyps: A Pragmatic Randomized Controlled Trial","volume":"176","author":"Chang L.\u2010C.","year":"2023","journal-title":"Annals of Internal Medicine"},{"key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1111\/den.14420","article-title":"Colorectal Cold Polypectomy: Current Standard Technique and Future Perspectives","volume":"35","author":"Ishibashi F.","year":"2023","journal-title":"Digestive Endoscopy"},{"issue":"5","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1111\/den.13173","article-title":"Efficacy and Safety of Cold versus Hot Snare Polypectomy for Resecting Small Colorectal Polyps: Systematic Review and Meta\u2010Analysis","volume":"30","author":"Shinozaki S.","year":"2018","journal-title":"Digestive Endoscopy"},{"issue":"1","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.15403\/jgld.2014.1121.271.hst","article-title":"Factors Associated With Possibly Inappropriate Histological Evaluation of Excised Specimens in Cold\u2010Snare Polypectomy for Small Colorectal Polyps","volume":"27","author":"Shimodate Y.","year":"2018","journal-title":"Journal of Gastrointestinal and Liver Diseases"},{"issue":"2","key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1111\/jgh.14409","article-title":"Endoscopic Prediction of Advanced Histology in Diminutive and Small Colorectal Polyps","volume":"34","author":"Iwai T.","year":"2019","journal-title":"Journal of Gastroenterology and Hepatology"},{"issue":"6","key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"e295","DOI":"10.1111\/codi.12210","article-title":"Clinicopathological Features of Colorectal Polyps: Evaluation of the \u2018Predict, Resect and Discard\u2019 strategies","volume":"15","author":"Sakamoto T.","year":"2013","journal-title":"Colorectal Disease"},{"issue":"2","key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1111\/jgh.14824","article-title":"Does Cold Snare Polypectomy Completely Resect the Mucosal Layer? A Prospective Single\u2010Center Observational Trial","volume":"35","author":"Shichijo S.","year":"2020","journal-title":"Journal of Gastroenterology and Hepatology"},{"issue":"4","key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1016\/j.gie.2017.10.041","article-title":"Width and Depth of Resection for Small Colorectal Polyps: Hot versus Cold Snare Polypectomy","volume":"87","author":"Suzuki S.","year":"2018","journal-title":"Gastrointestinal Endoscopy"},{"issue":"4","key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1111\/j.1443-1661.2010.01016.x","article-title":"Current Status in the Occurrence of Postoperative Bleeding, Perforation and Residual\/Local Recurrence during Colonoscopic Treatment in Japan","volume":"22","author":"Oka S.","year":"2010","journal-title":"Digestive Endoscopy"},{"issue":"4","key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/jgh.16452","article-title":"A Novel Low\u2010Power Pure\u2010Cut Hot Snare Polypectomy for 10\u201314 Mm Colorectal Adenomas: An Ex Vivo and a Clinical Prospective Feasibility Study (SHARP trial)","volume":"39","author":"Imai K.","year":"2024","journal-title":"Journal of Gastroenterology and Hepatology"},{"issue":"9","key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1111\/jgh.16616","article-title":"Low\u2010Power Pure\u2010Cut Hot Snare Polypectomy for Colorectal Polyps 10\u201314 Mm in Size: A Multicenter Retrospective Study","volume":"39","author":"Kimura H.","year":"2024","journal-title":"Journal of Gastroenterology and Hepatology"},{"issue":"1","key":"e_1_2_12_18_1","doi-asserted-by":"crossref","DOI":"10.1002\/deo2.378","article-title":"Safety and Efficacy of Low\u2010Power Pure\u2010Cut Hot Snare Polypectomy for Small Nonpedunculated Colorectal Polyps Compared With Conventional Resection Methods: A Propensity Score Matching Analysis","volume":"5","author":"Kimura H.","year":"2024","journal-title":"DEN Open"},{"issue":"6","key":"e_1_2_12_19_1","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/S0016-5107(03)02159-X","article-title":"The Paris Endoscopic Classification of Superficial Neoplastic Lesions: Esophagus, Stomach, and Colon: November 30 to December 1, 2002","volume":"58","author":"Participants in the Paris Workshop","year":"2003","journal-title":"Gastrointestinal Endoscopy"},{"issue":"4","key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.23922\/jarc.2019-018","article-title":"Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma: The 3rd English Edition [Secondary Publication]","volume":"3","author":"Japanese Society for Cancer of the Colon and Rectum","year":"2019","journal-title":"Journal of the Anus, Rectum and Colon"},{"issue":"5","key":"e_1_2_12_21_1","doi-asserted-by":"crossref","first-page":"856","DOI":"10.14309\/ajg.0000000000002634","article-title":"Resectability of Small Duodenal Tumors: A Randomized Controlled Trial Comparing Underwater Endoscopic Mucosal Resection and Cold Snare Polypectomy","volume":"119","author":"Miyazaki K.","year":"2024","journal-title":"American Journal of Gastroenterology"},{"issue":"1","key":"e_1_2_12_22_1","doi-asserted-by":"crossref","DOI":"10.1002\/deo2.70235","article-title":"Safety Profile of Low\u2010Power Pure\u2010Cut Hot Snare Polypectomy for 10\u201314 Mm Nonpedunculated Colorectal Neoplasms","volume":"6","author":"Takada K.","year":"2025","journal-title":"DEN Open"},{"issue":"9","key":"e_1_2_12_23_1","doi-asserted-by":"crossref","first-page":"5096","DOI":"10.1007\/s00464-020-07994-7","article-title":"Hot Snare Polypectomy versus Endoscopic Mucosal Resection for Small Colorectal Polyps: A Randomized Controlled Trial","volume":"35","author":"Kim S.\u2010J.","year":"2021","journal-title":"Surgical Endoscopy"},{"issue":"1","key":"e_1_2_12_24_1","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1186\/s12876-020-01457-y","article-title":"Underwater versus Conventional Endoscopic Mucosal Resection for Small Size Non\u2010Pedunculated Colorectal Polyps: A Randomized Controlled Trial (UEMR vs. CEMR for small size non\u2010Pedunculated colorectal polyps)","volume":"20","author":"Zhang Z.","year":"2020","journal-title":"BMC Gastroenterology [Electronic Resource]"},{"issue":"11","key":"e_1_2_12_25_1","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1007\/s00535-018-1446-2","article-title":"Resection Depth and Layer of Cold Snare Polypectomy versus Endoscopic Mucosal Resection","volume":"53","author":"Ito A.","year":"2018","journal-title":"Journal of Gastroenterology"},{"issue":"2","key":"e_1_2_12_26_1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1055\/s-0032-1325930","article-title":"Comparison Between Tungsten and Steel Polypectomy Snares: Evaluation of Depth of Colonic Thermal Wall Injury in a Pig Model","volume":"45","author":"Galloro G.","year":"2013","journal-title":"Endoscopy"},{"issue":"6","key":"e_1_2_12_27_1","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1111\/den.12661","article-title":"Multicenter Randomized Study to Assess the Effect of Prophylactic Clipping on Post\u2010Polypectomy Delayed Bleeding","volume":"28","author":"Matsumoto M.","year":"2016","journal-title":"Digestive Endoscopy"},{"issue":"4","key":"e_1_2_12_28_1","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1053\/j.gastro.2019.03.019","article-title":"Clip Closure Prevents Bleeding after Endoscopic Resection of Large Colon Polyps in a Randomized Trial","volume":"157","author":"Pohl H.","year":"2019","journal-title":"Gastroenterology"}],"container-title":["DEN Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70450","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/deo2.70450","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70450","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:56:27Z","timestamp":1791863787000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/deo2.70450"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2027,4]]}},"alternative-id":["10.1002\/deo2.70450"],"URL":"https:\/\/doi.org\/10.1002\/deo2.70450","archive":["Portico"],"relation":{},"ISSN":["2692-4609","2692-4609"],"issn-type":[{"value":"2692-4609","type":"print"},{"value":"2692-4609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]},"assertion":[{"value":"2026-08-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70450"}}