Bleeding risk and prevention after colorectal polypectomy: What differs between cold and hot resection?

doi:10.4253/wjge.121774

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World Journal of Gastrointestinal Endoscopy

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1948-5190

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Endosc. Aug 16, 2026; 18(8): 121774
Published online Aug 16, 2026. doi: 10.4253/wjge.121774

Bleeding risk and prevention after colorectal polypectomy: What differs between cold and hot resection?

Zhi-Gang Lin, Kai Deng

Zhi-Gang Lin, Kai Deng, Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China

Author contributions: Lin ZG collected and reviewed relevant literature; Deng K drafted the original manuscript; Lin ZG and Deng K conceived and designed the manuscript, critically revised the manuscript for important intellectual content, and read and approved the final version.

AI contribution statement: The authors take full responsibility and accountability for all content of this manuscript, including any portions for which AI tools were used as assistive technologies. All AI-assisted outputs were carefully reviewed, validated, and approved by the authors. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.

Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.

Corresponding author: Kai Deng, MD, PhD, Associate Professor, Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, Sichuan Province, China. dengkai@wchscu.cn

Received: April 2, 2026
Revised: June 9, 2026
Accepted: June 29, 2026
Published online: August 16, 2026
Processing time: 131 Days and 1.6 Hours

Core Tip

Core Tip: Bleeding risk after colorectal polypectomy differs between cold and hot resection because the mechanisms of tissue injury are distinct. Cold resection generally lowers delayed bleeding by avoiding thermal injury, whereas endoscopic mucosal resection and endoscopic submucosal dissection carry bleeding risks related to electrocautery and post-procedural necrosis. Prevention should be individualized according to resection method, lesion characteristics, antithrombotic exposure, and the potential benefit of prophylactic closure.