{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:38:05Z","timestamp":1792712285406,"version":"4.5.0"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","funder":[{"name":"Clinical Research Excellence Program for Research-Oriented Wards","award":["BRWEP2024W034010104"],"award-info":[{"award-number":["BRWEP2024W034010104"]}]},{"name":"Science and Technology Projects of Xizang Autonomous Region, China","award":["XZ202501JD0021"],"award-info":[{"award-number":["XZ202501JD0021"]}]},{"name":"Science and Technology Projects of Xizang Autonomous Region, China","award":["XZ202501ZY0072"],"award-info":[{"award-number":["XZ202501ZY0072"]}]},{"name":"National Key Research and Development Program of China","award":["2024YFA0918500"],"award-info":[{"award-number":["2024YFA0918500"]}]},{"name":"National High Level Hospital Clinical Research Funding","award":["2025-PUMCH-C-048"],"award-info":[{"award-number":["2025-PUMCH-C-048"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Evidence for cold snare endoscopic mucosal resection (CS-EMR) in 10\u201319-mm nonpedunculated colorectal polyps is scarce. We conducted a multicenter randomized controlled trial (RCT) to compare CS-EMR against hot snare EMR (HS-EMR) in this setting.<\/jats:p>\n                  <jats:p>We enrolled patients with 10\u201319-mm nonpedunculated colorectal polyps from 15 centers. Eligible polyps were individually randomized (1:1) to CS-EMR or HS-EMR. The primary outcome was histologic complete resection, analyzed in modified intention-to-treat (mITT) and per-protocol (PP) populations (noninferiority margin \u221210%). Secondary outcomes included en bloc resection, intraprocedural and delayed adverse events, and resection time.<\/jats:p>\n                  <jats:p>216 patients with 233 eligible polyps were included (CS-EMR 116; HS-EMR 117). In the mITT analysis, complete resection was 90.4% in the CS-EMR group and 93.2% in the HS-EMR group (difference \u22122.7%, 95%CI \u22129.8 to 4.3), showing noninferiority of CS-EMR vs. HS-EMR. PP results were consistent (CS-EMR 93.3%; HS-EMR 93.2%; difference 0.2%, 95%CI \u22126.7 to 7.1). CS-EMR was noninferior for 10\u201314-mm polyps (94.3% vs. 94.0%; 95%CI \u22126.8 to 7.2) but not for 15\u201319-mm polyps (78.6% vs. 90.9%; 95%CI \u221230.4 to 5.8), although interaction was not significant. En bloc resection rates and resection time were similar between groups. Intraprocedural bleeding was more frequent with CS-EMR (19.1% vs. 3.4%), whereas delayed bleeding was rare (0.0% vs. 0.9%), and no perforation occurred in either group.<\/jats:p>\n                  <jats:p>CS-EMR was noninferior to HS-EMR for histologic complete resection of 10\u201319-mm nonpedunculated colorectal polyps, but its applicability to 15\u201319-mm lesions remains uncertain.<\/jats:p>","DOI":"10.1055\/a-2955-8772","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T22:45:17Z","timestamp":1792709117000},"source":"Crossref","is-referenced-by-count":0,"title":["Cold versus hot snare endoscopic mucosal resection for 10\u201319-mm nonpedunculated colorectal polyps: a multicenter randomized trial"],"prefix":"10.1055","clinical-trial-number":[{"clinical-trial-number":"nct05545787","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Qingwei","family":"Jiang","sequence":"additional","affiliation":[{"name":"Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China","place":["Beijing"],"department":["Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiyi","family":"An","sequence":"additional","affiliation":[{"name":"Peking Union Medical College Graduate School, Beijing, China","place":["Beijing"],"department":["Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaxiao","family":"Yan","sequence":"additional","affiliation":[{"name":"Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China","place":["Beijing"],"department":["Department of Emergency, State Key Laboratory of Complex Severe and Rare Diseases, Critical and Emergency Pharmaceuticals & Medical Devices Innovation 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China","place":["Beijing"],"department":["Senior Department of Gastroenterology"]},{"name":"The Seventh Medical Center of Chinese PLA General Hospital, China","place":["Beijing"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjie","family":"Ren","sequence":"additional","affiliation":[{"name":"First Hospital of Shanxi Medical University, China","place":["Taiyuan"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pan","family":"Li","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Chongqing Medical University, China","place":["Chongqing"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Tu","sequence":"additional","affiliation":[{"name":"Sichuan University, China","place":["Chengdu"],"department":["Department of Gastroenterology, West China Longquanyi Hospital"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Ding","sequence":"additional","affiliation":[{"name":"Henan Province People's Hospital, China","place":["Zhengzhou"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ailing","family":"Liu","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Qingdao University, China","place":["Qingdao"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dekun","family":"Yang","sequence":"additional","affiliation":[{"name":"Beijing Fangshan District Liangxiang Hospital, China","place":["Beijing"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhizhi","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Nanchang University and China Jiangxi Clinical Research Center for Gastroenterology, China","place":["Nanchang"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Liu","sequence":"additional","affiliation":[{"name":"Beijing Sixth Hospital, China","place":["Beijing"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruigang","family":"Wang","sequence":"additional","affiliation":[{"name":"Beijing Tsinghua Changgung Hospital, China","place":["Beijing"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanhong","family":"Tang","sequence":"additional","affiliation":[{"name":"People's Liberation Army The General Hospital of Western Theater Command, China","place":["Chengdu"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Jin","sequence":"additional","affiliation":[{"name":"Emergency General Hospital, China","place":["Beijing"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2907-7904","authenticated-orcid":false,"given":"Ai-Ming","family":"Yang","sequence":"additional","affiliation":[{"name":"Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China","place":["Beijing"],"department":["Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6439-3761","authenticated-orcid":false,"given":"Dong","family":"Wu","sequence":"additional","affiliation":[{"name":"Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China","place":["Beijing"],"department":["Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1053\/j.gastro.2012.09.043","article-title":"Incomplete polyp resection during colonoscopy-results of the complete adenoma resection (CARE) study","volume":"144","author":"H Pohl","year":"2013","journal-title":"Gastroenterology"},{"key":"ref2","doi-asserted-by":"publisher","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":"S Suzuki","year":"2018","journal-title":"Gastrointest 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Nogales","year":"2025","journal-title":"Endoscopy"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1053\/j.gastro.2024.05.013","article-title":"Cold versus hot snare endoscopic resection of large nonpedunculated colorectal polyps: randomized controlled German CHRONICLE trial","volume":"167","author":"I Steinbr\u00fcck","year":"2024","journal-title":"Gastroenterology"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1823","DOI":"10.1136\/gutjnl-2024-332807","article-title":"Cold versus hot snare endoscopic mucosal resection for large (\u226515 mm) flat non-pedunculated colorectal polyps: a randomised controlled trial","volume":"73","author":"T O\u2019Sullivan","year":"2024","journal-title":"Gut"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"328","DOI":"10.3748\/wjg.v23.i2.328","article-title":"Removal of diminutive colorectal polyps: a prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy","volume":"23","author":"Y Komeda","year":"2017","journal-title":"World J Gastroenterol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1055\/a-1734-7952","article-title":"Complete polyp resection with cold snare versus hot snare polypectomy for polyps of 4\u20139 mm: a randomized controlled trial","volume":"54","author":"IB Pedersen","year":"2022","journal-title":"Endoscopy"},{"key":"ref10","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":"ref11","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1016\/j.cgh.2023.10.012","article-title":"AGA Clinical Practice Update on Appropriate and Tailored Polypectomy: Expert Review","volume":"22","author":"A Copland","year":"2024","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1053\/j.gastro.2019.12.018","article-title":"Endoscopic removal of colorectal lesions-recommendations by the US Multi-Society Task Force on Colorectal Cancer","volume":"158","author":"T Kaltenbach","year":"2020","journal-title":"Gastroenterology"},{"key":"ref13","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":"ref14","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1016\/j.gie.2022.03.006","article-title":"Cold versus hot snare resection with or without submucosal injection of 6- to 15-mm colorectal polyps: a randomized controlled trial","volume":"96","author":"DK Rex","year":"2022","journal-title":"Gastrointestinal Endoscopy"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1002\/ueg2.12130","article-title":"Cold versus hot polypectomy\/endoscopic mucosal resection \u2013 a review of current evidence","volume":"9","author":"R Ortig\u00e3o","year":"2021","journal-title":"United European Gastroenterol J"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-070321","article-title":"Endoscopic mucosal resection using cold snare versus hot snare in treatment for 10\u201319 mm non-pedunculated colorectal polyps: protocol of a non-inferiority randomised controlled study","volume":"13","author":"Q Jiang","year":"2023","journal-title":"BMJ Open"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2024-081123","article-title":"CONSORT 2025 statement: updated guideline for reporting randomised trials","volume":"389","author":"S Hopewell","year":"2025","journal-title":"BMJ"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1055\/s-0042-105557","article-title":"Comparison between endoscopic mucosal resection and hot snare resection of large nonpedunculated colorectal polyps: a randomized trial","volume":"48","author":"A Horiuchi","year":"2016","journal-title":"Endoscopy"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1055\/s-0043-118594","article-title":"Cold versus hot endoscopic mucosal resection for nonpedunculated colorectal polyps sized 6\u201310 mm: a randomized trial","volume":"50","author":"V Papastergiou","year":"2018","journal-title":"Endoscopy"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.14309\/ajg.0000000000001799","article-title":"Randomized controlled trial investigating cold snare and forceps polypectomy among small polyps in rates of complete resection: the TINYPOLYP trial","volume":"117","author":"MT Wei","year":"2022","journal-title":"Am J Gastroenterol"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1177\/17562848251338672","article-title":"New chapter in precision medicine: strategies for endoscopic resection of 10\u201320\u2009mm non-pedunculated colorectal polyps","volume":"18","author":"C Duan","year":"2025","journal-title":"Therap Adv Gastroenterol"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/j.gie.2020.05.039","article-title":"Impact of submucosal saline solution injection for cold snare polypectomy of small colorectal polyps: a randomized controlled study","volume":"92","author":"Y Shimodate","year":"2020","journal-title":"Gastrointest Endosc"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1055\/a-2029-9539","article-title":"Effectiveness and safety of cold snare polypectomy and cold endoscopic mucosal resection for nonpedunculated colorectal polyps of 10\u201319 \u200amm: a multicenter observational cohort study","volume":"55","author":"D Mangira","year":"2023","journal-title":"Endoscopy"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1016\/j.gie.2024.12.032","article-title":"Cold- versus hot-snare endoscopic mucosal resection of colorectal polyps: meta-analysis of randomized controlled trials","volume":"101","author":"A Saeed","year":"2025","journal-title":"Gastrointestinal Endoscopy"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1055\/a-1978-3277","article-title":"Incomplete resection of colorectal polyps of 4\u201320\u200amm in size when using a cold snare, and its associated factors","volume":"55","author":"D von Renteln","year":"2023","journal-title":"Endoscopy"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1016\/j.gie.2015.02.012","article-title":"Prospective, randomized comparison of 2 methods of cold snare polypectomy for small colorectal polyps","volume":"82","author":"A Horiuchi","year":"2015","journal-title":"Gastrointest Endosc"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"76","DOI":"10.5217\/ir.2025.00189","article-title":"Does the size of the cold snare affect the outcome of cold snare polypectomy in the colon? A KASID prospective multicenter study","volume":"24","author":"S Choi","year":"2026","journal-title":"Intest Res"},{"key":"ref28","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":"L-C Chang","year":"2023","journal-title":"Ann Intern Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1002\/jgh3.12243","article-title":"Complications of cold versus hot snare polypectomy of 10\u201320\u2009mm polyps: a retrospective cohort study","volume":"4","author":"SN Ket","year":"2020","journal-title":"JGH Open"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1016\/j.gie.2020.05.019","article-title":"Efficacy and safety of cold-snare endoscopic mucosal resection for colorectal adenomas 10 to 14 mm in size: a prospective observational study","volume":"92","author":"Y Yabuuchi","year":"2020","journal-title":"Gastrointest Endosc"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1055\/s-0043-100215","article-title":"Incomplete resection rate of cold snare polypectomy: a prospective single-arm observational study","volume":"49","author":"N Matsuura","year":"2017","journal-title":"Endoscopy"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"e132","DOI":"10.1016\/j.cgh.2020.10.053","article-title":"Safety and efficacy of cold snare polypectomy without submucosal injection for large sessile serrated lesions: a prospective study","volume":"20","author":"Y Kimoto","year":"2022","journal-title":"Clin Gastroenterol Hepatol"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2955-8772.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T22:45:20Z","timestamp":1792709120000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2955-8772"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,22]]},"references-count":32,"URL":"https:\/\/doi.org\/10.1055\/a-2955-8772","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,22]]}}}