Postoperative recovery and bleeding risk after endoscopic snare cold resection in patients with 5-15 mm colorectal polyps

Abstract

BACKGROUND

Endoscopic cold snare resection (CSP) can enhance postoperative recovery and minimize bleeding risk in patients with 5-15 mm colorectal polyps. However, more detailed evaluations are required to assess their advantages over conventional methods.

AIM

To evaluate the effects of endoscopic CSP on postoperative recovery and bleeding risk in patients with 5-15 mm colorectal polyps.

METHODS

This randomized controlled study included 193 patients (mean age: 57.91 ± 5.41 years; 97 men and 96 women) with 5-15 mm colorectal polyps treated at Dongyang People's Hospital between March and June 2023. The patients were randomly assigned to the experimental group (n = 100), who underwent CSP, and the control group (n = 93), who underwent conventional endoscopic mucosal resection (EMR). Operation time, hospital stay, dietary status, and bleeding rate within 3 days were compared.

RESULTS

The CSP group had significantly shorter operation times (15.02 ± 2.44 minutes vs 18.78 ± 5.48 minutes, P < 0.001) and hospital stays (3.11 ± 1.08 days vs 4.89 ± 1.35 days, P < 0.001) than the EMR group. The fasting rate on the day of surgery was also lower in the CSP group (P < 0.05). The complete resection rates were similar between groups (98.00% vs 94.62%, P = 0.210), and no perforations occurred in either group. The 3-day postoperative bleeding rate was slightly lower in the CSP group (2.00%) than in the EMR group (6.45%), although this difference was not statistically significant (P = 0.234), indicating limited clinical relevance.

CONCLUSION

CSP was safe and efficient for removing 5-15 mm colorectal polyps, offering faster recovery and comparable safety to EMR. The procedural efficiency of CSP supports its broad clinical application.

Keywords: Endoscopic cold snare resection; Colorectal polyps; Postoperative recovery; Bleeding rate; Randomized controlled trial

Core Tip: We compared endoscopic cold snare polypectomy (CSP) with conventional endoscopic mucosal resection in 193 patients with 5-15 mm colorectal polyps. CSP demonstrated advantages in postoperative recovery, including shorter operative time, reduced hospitalization, and lower fasting rates on the day of surgery. Despite similar complete resection rates and no perforation in both groups, CSP showed a marginally lower but statistically comparable bleeding risk within 3 postoperative days postoperatively. With comparable safety profiles and superior recovery outcomes, CSP has emerged as a practical option for small-to-medium-sized colorectal polyps aligned with fast-track surgical goals.