Removal of diminutive colorectal polyps: A prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy

Figure 1 Enrollment flowchart. CSP: Cold snare polypectomy; HFB: Hot forceps biopsy; EMR: Endoscopic mucosal resection.

Figure 2 Technique for cold snare polypectomy. A: Chromoendoscopy was used to detect the polyp and surrounding normal mucosa, which were captured with a snare, and resection was performed without electrocautery; B: The mucosal defect was assessed to ensure complete resection and no persistent bleeding; C: The free cut-margin was negative for neoplastic tissue (area between the arrows).

Figure 3 Technique for hot forceps biopsy. A: A slightly protruded polyp was detected with magnified chromoendoscopy; B: The polyp was captured in the cup of the forceps and gently pulled from the mucosa; C: The electrocautery current was applied to the polyp until the color changed to white at the polyp base. Then the polyp was completely removed from the mucosa; D: Pathologic evaluation of the free cut-margin was difficult to perform because of a thermal tissue injury (arrow).