{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:27:58Z","timestamp":1792841278637,"version":"4.5.0"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"07","funder":[{"name":"Ningbo Science and Technology Public Welfare","award":["2023S133"],"award-info":[{"award-number":["2023S133"]}]},{"name":"Ningbo Leading Medical & Healthy Discipline Project","award":["2022--S04"],"award-info":[{"award-number":["2022--S04"]}]},{"name":"Ningbo Top Medical and Health Research 22 Program","award":["2023020612"],"award-info":[{"award-number":["2023020612"]}]},{"name":"First Affiliated Hospital of Ningbo University","award":["2023B046"],"award-info":[{"award-number":["2023B046"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cold snare polypectomy (CSP) is effective in minimizing delayed postpolypectomy bleeding (DPPB) after resection of pedunculated colorectal polyps. However, robust randomized controlled trial (RCT) evidence remains limited. We aimed to compare the safety of CSP with that of hot snare polypectomy (HSP) for pedunculated polyps.<\/jats:p>\n                  <jats:p>A prospective, multicenter, single-blind RCT was conducted across four endoscopy centers in China. Pedunculated colorectal polyps identified via endoscopy, with heads &lt;20 mm and stalk thickness \u22645 mm, were randomly allocated to CSP or HSP. The primary outcome was DPPB within 30 days after polypectomy.<\/jats:p>\n                  <jats:p>189 polyps were included (CSP 94, HSP 95). The majority of polyps in both groups had head diameters of 6\u201315 mm (182\/189). Compared with HSP, CSP was associated with a lower risk of DPPB (0% vs. 6.3%; risk difference \u20130.06 [95%CI \u20130.11 to \u20130.01]). However, CSP was associated with a greater occurrence of immediate postpolypectomy bleeding (86.2% vs. 12.6%; risk difference 0.74 [95%CI 0.64 to 0.83]), although no further severe adverse clinical events were observed. The polypectomy time was shorter with CSP than with HSP (25.0 vs. 57.0 seconds; median difference, \u201332.0 seconds [95%CI \u201341.00 to \u201322.50]). These findings primarily reflect polyps with heads \u226415 mm (99.5% [188\/189]; no &gt;15-mm heads in CSP).<\/jats:p>\n                  <jats:p>CSP was associated with a reduced risk of DPPB compared with HSP in pedunculated colorectal polyps with heads \u226415 mm and stalks \u22645 mm, although its applicability to polyps with heads of 16\u201319 mm remains uncertain.<\/jats:p>","DOI":"10.1055\/a-2827-0879","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T22:56:15Z","timestamp":1776984975000},"page":"766-775","source":"Crossref","is-referenced-by-count":2,"title":["Cold versus hot snare polypectomy for pedunculated colorectal polyps: a multicenter randomized controlled trial"],"prefix":"10.1055","volume":"58","clinical-trial-number":[{"clinical-trial-number":"nct06097650","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Shisong","family":"Wang","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Ningbo University, China","place":["Ningbo"],"department":["Department of Gastroenterology"]},{"name":"Ningbo University, China","place":["Ningbo"],"department":["Health Science Center"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Gao","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Ningbo University, China","place":["Ningbo"],"department":["Department of Gastroenterology"]},{"name":"The First Affiliated Hospital of Ningbo University, China","place":["Ningbo"],"department":["Zhejiang Provincial Clinical Research Centre for Digestive Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganhua","family":"Guo","sequence":"additional","affiliation":[{"name":"Cixi Third People's Hospital Medical Health Group, China","place":["Ningbo"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihui","family":"Xu","sequence":"additional","affiliation":[{"name":"Ninghai Second Hospital, China","place":["Ningbo"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Miao","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Ningbo University, China","place":["Ningbo"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianzhong","family":"Sang","sequence":"additional","affiliation":[{"name":"Yuyao City People's Hospital, China","place":["Ningbo"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghong","family":"Xia","sequence":"additional","affiliation":[{"name":"Ninghai Second Hospital, China","place":["Ningbo"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoqun","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Ningbo University, China","place":["Ningbo"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixin","family":"Zhang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Ningbo University, China","place":["Ningbo"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenfei","family":"Bao","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Ningbo University, China","place":["Ningbo"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weihong","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Ningbo University, China","place":["Ningbo"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiarong","family":"Xie","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Ningbo University, China","place":["Ningbo"],"department":["Department of Gastroenterology"]},{"name":"The First Affiliated Hospital of Ningbo University, China","place":["Ningbo"],"department":["Zhejiang Provincial Clinical Research Centre for Digestive Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6017-3745","authenticated-orcid":false,"given":"Lei","family":"Xu","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Ningbo University, China","place":["Ningbo"],"department":["Department of Gastroenterology"]},{"name":"The First Affiliated Hospital of Ningbo University, China","place":["Ningbo"],"department":["Zhejiang Provincial Clinical Research Centre for Digestive Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1056\/NEJMoa1100370","article-title":"Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths","volume":"366","author":"AG Zauber","year":"2012","journal-title":"N Engl J Med"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1016\/j.gie.2005.11.063","article-title":"Blood supply of colorectal polyps correlates with risk of bleeding after colonoscopic polypectomy","volume":"63","author":"S Dobrowolski","year":"2006","journal-title":"Gastrointest Endosc"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1053\/j.gastro.2019.12.018","article-title":"Endoscopic removal of colorectal lesions \u2013 recommendations by the US Multi-Society Task Force on Colorectal Cancer","volume":"158","author":"T Kaltenbach","year":"2020","journal-title":"Gastroenterology"},{"key":"ref4","doi-asserted-by":"publisher","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":"LC Chang","year":"2023","journal-title":"Ann Intern Med"},{"key":"ref5","doi-asserted-by":"publisher","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-analysis","volume":"30","author":"S Shinozaki","year":"2018","journal-title":"Dig Endosc"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1111\/den.14420","article-title":"Colorectal cold snare polypectomy: current standard technique and future perspectives","volume":"35","author":"F Ishibashi","year":"2023","journal-title":"Dig Endosc"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1055\/a-2304-3219","article-title":"Colorectal polypectomy and endoscopic mucosal resection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline \u2013 update 2024","volume":"56","author":"M Ferlitsch","year":"2024","journal-title":"Endoscopy"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"2353","DOI":"10.1007\/s10620-020-06436-7","article-title":"Management of less than 10-mm-sized pedunculated (Ip) polyps with thin stalk: hot snare polypectomy versus cold snare polypectomy","volume":"66","author":"J Arimoto","year":"2021","journal-title":"Dig Dis Sci"},{"key":"ref9","first-page":"411","article-title":"Pedunculated colorectal polyps with heads \u22641 cm in diameter can be resected using cold snare polypectomy","volume":"84","author":"T Kudo","year":"2021","journal-title":"Acta Gastroenterol 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Kim","year":"2006","journal-title":"Am J Gastroenterol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1055\/s-0034-1390795","article-title":"Water exchange versus carbon dioxide insufflation in unsedated colonoscopy: a multicenter randomized controlled trial","volume":"47","author":"K Garborg","year":"2015","journal-title":"Endoscopy"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/j.cgh.2018.08.005","article-title":"Patient, procedure, and endoscopist risk factors for perforation, bleeding, and splenic injury after colonoscopies","volume":"17","author":"M Laanani","year":"2019","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1055\/s-0032-1326104","article-title":"Clinical outcomes and risk factors of post-polypectomy coagulation syndrome: a multicenter, retrospective, case\u2013control study","volume":"45","author":"JM Cha","year":"2013","journal-title":"Endoscopy"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1055\/s-0033-1344987","article-title":"Risk factors for adverse events related to polypectomy in the English Bowel Cancer Screening Programme","volume":"46","author":"MD Rutter","year":"2014","journal-title":"Endoscopy"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1136\/flgastro-2013-100331","article-title":"A novel method for determining the difficulty of colonoscopic polypectomy","volume":"4","author":"S Gupta","year":"2013","journal-title":"Frontline Gastroenterol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1097\/MCG.0000000000001699","article-title":"Bleeding risk with cold snare polypectomy of \u226410\u2009mm pedunculated colon polyps","volume":"57","author":"H Fatima","year":"2023","journal-title":"J Clin 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Ji","year":"2024","journal-title":"Surg Endosc"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/j.gie.2012.10.024","article-title":"Prophylactic clip closure reduced the risk of delayed postpolypectomy hemorrhage: experience in 277 clipped large sessile or flat colorectal lesions and 247 control lesions","volume":"77","author":"H Liaquat","year":"2013","journal-title":"Gastrointest Endosc"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/S2468-1253(21)00384-8","article-title":"Effect of prophylactic endoscopic clip placement on clinically significant post-endoscopic mucosal resection bleeding in the right colon: a single-centre, randomised controlled trial","volume":"7","author":"S Gupta","year":"2022","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1053\/j.gastro.2019.05.003","article-title":"Efficacy of prophylactic hemoclips in prevention of delayed post-polypectomy bleeding in patients with large colonic polyps","volume":"157","author":"LA Feagins","year":"2019","journal-title":"Gastroenterology"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1053\/j.gastro.2020.03.051","article-title":"Prophylactic clipping after colorectal endoscopic resection prevents bleeding of large, proximal polyps: meta-analysis of randomized trials","volume":"159","author":"M Spadaccini","year":"2020","journal-title":"Gastroenterology"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1038\/ajg.2016.287","article-title":"Comparison of efficacy of prophylactic endoscopic therapies for postpolypectomy bleeding in the colorectum: a systematic review and network meta-analysis","volume":"111","author":"CH Park","year":"2016","journal-title":"Am J Gastroenterol"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1053\/j.gastro.2020.03.014","article-title":"Effects of blended (yellow) vs forced coagulation (blue) currents on adverse events, complete resection, or polyp recurrence after polypectomy in a large randomized trial","volume":"159","author":"H Pohl","year":"2020","journal-title":"Gastroenterology"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1016\/j.gie.2017.10.038","article-title":"Utility of multi-detector computed tomography scans after colorectal endoscopic submucosal dissection: a prospective study","volume":"87","author":"R Kobayashi","year":"2018","journal-title":"Gastrointest Endosc"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1097\/MCG.0000000000001848","article-title":"Cold snare polypectomy in small (<10 mm) pedunculated colorectal polyps: a systematic review and meta-analysis","volume":"58","author":"A Canakis","year":"2024","journal-title":"J Clin 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