Evaluation of efficacy and safety of different endoscopic polypectomy techniques for colonic polyps

doi:10.4240/wjgs.v17.i9.110347

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World Journal of Gastrointestinal Surgery

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1948-9366

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

Retrospective Cohort Study

World J Gastrointest Surg. Sep 27, 2025; 17(9): 110347
Published online Sep 27, 2025. doi: 10.4240/wjgs.v17.i9.110347

Table 1 Demographic characteristics of the study population, mean ± SD/n (%)

Parameters	HFE (n = 107)	CSP (n = 106)	EMR (n = 108)	P¹ value	P² value	P³ value
Age (years)	57.90 ± 13.20	56.80 ± 11.61	57.29 ± 12.35	1.551	2.289	2.172
Gender				2.847	2.658	2.505
Male	57 (53.27)	56 (53.27)	56 (51.85)
Female	50 (46.73)	50 (46.73)	52 (48.15)
Smoking	22 (20.56)	22 (20.56)	22 (20.37)	2.916	2.835	2.916
Drinking	35 (79.44)	38 (32.71)	38 (35.18)	1.887	2.757	2.106
Course of disease, months	14.24 ± 2.45	14.31 ± 2.25	14.08 ± 2.92	2.517	1.557	1.989
Hypertension	20 (18.69)	21 (19.81)	22 (20.37)	2.508	2.757	2.268
Diabetes	11 (10.28)	10 (9.43)	13 (12.03)	2.508	1.617	2.049
Hyperlipidemia	20 (18.69)	22 (20.75)	23 (21.29)	2.115	2.769	1.899
Coronary heart disease	8 (7.48)	6 (5.89)	8 (7.15)	1.779	1.815	2.955
Indication				2.796	2.832	2.904
Screening	33 (30.84)	36 (33.96)	35 (32.63)
Follow up	19 (17.76)	16 (15.09)	21 (19.44)
For polypectomy	22 (20.56)	22 (20.75)	22 (19.45)
Positive FOBT	6 (5.61)	8 (7.55)	7 (6.48)
Symptoms	27 (25.23)	24 (22.64)	23 (21.29)
Bowel preparation				2.235	2.199	3.000
BBPS < 6	5 (4.67)	6 (5.66)	5 (4.62)
BBPS ≥ 6	102 (95.33)	100 (94.34)	103 (95.38)

¹High-frequency electroresection vs cold snare polypectomy.

²Cold snare polypectomy vs endoscopic mucosal resection.

³High-frequency electroresection vs endoscopic mucosal resection.

HFE: High-frequency electroresection; CSP: Cold snare polypectomy; EMR: Endoscopic mucosal resection; FOBT: Fecal occult blood test; BBPS: Boston Bowel Preparation Scale.

Full Size Table

Table 2 Preoperative laboratory blood tests, mean ± SD

Parameters	HFE (n = 107)	CSP (n = 106)	EMR (n = 108)	P¹ value	P² value	P³ value
Prothrombin time (seconds)	11.54 ± 1.02	11.25 ± 1.73	11.73 ± 1.45	0.837	0.093	0.759
White blood cell count (× 10⁹/L)	5.89 ± 1.12	5.74 ± 1.28	5.52 ± 1.34	1.104	0.633	0.090
Platelet count (× 10⁹/L)	205.37 ± 54.99	208.37 ± 52.75	211.76 ± 51.84	2.055	1.905	1.146
Hemoglobin (g/L)	147.63 ± 16.93	145.72 ± 14.13	144.72 ± 16.21	1.113	1.887	0.597

¹High-frequency electroresection vs cold snare polypectomy.

²Cold snare polypectomy vs endoscopic mucosal resection.

³High-frequency electroresection vs endoscopic mucosal resection.

HFE: High-frequency electroresection; CSP: Cold snare polypectomy; EMR: Endoscopic mucosal resection.

Full Size Table

Table 3 Clinical characteristics of the polyps, n (%)

Parameters	HFE (n = 107)	CSP (n = 106)	EMR (n = 108)	P¹ value	P² value	P³ value
Polyp diameter (mm)	10.61 ± 2.25	7.89 ± 2.12^c	14.20 ± 1.65^c^,^e	< 0.001	< 0.001	< 0.001
Location				1.824	0.857	2.214
Proximal colon	65 (60.75)	68 (64.15)	68 (62.96)
Distal colon	42 (39.25)	38 (35.85)	40 (37.04)
Morpholog				1.068	0.919	1.227
Flat	32 (29.91)	38 (35.85)	38 (35.18)
Protruded	75 (70.09)	68 (64.15)	70 (64.82)
Histopathology				2.523	0.850	1.809
TA with LGD	104 (97.2)	101 (95.28)	101 (93.52)
TA with HGD	1 (0.93)	1 (0.94)	3 (2.78)
TVA	1 (0.93)	1 (0.94)	1 (0.92)
SSA/P	1 (0.93)	3 (2.83)	3 (2.78)

¹High-frequency electroresection vs cold snare polypectomy.

²Cold snare polypectomy vs endoscopic mucosal resection.

³High-frequency electroresection vs endoscopic mucosal resection.

^cP < 0.001 vs high-frequency electroresection group.

^eP < 0.001 vs cold snare polypectomy group.

HFE: High-frequency electroresection; CSP: Cold snare polypectomy; EMR: Endoscopic mucosal resection; LGD: Low-grade dysplasia; HGD: High-grade dysplasia; TA: Tubular adenoma; TVA: Tubulovillous adenoma; SSA/P: Sessile serrated adenoma/polyp.

Full Size Table

Table 4 Surgical details, mean ± SD/n (%)

Parameters	HFE (n = 107)	CSP (n = 106)	EMR (n = 108)	P¹ value	P² value	P³ value
Total procedure time (minutes)	29.38 ± 2.11	32.58 ± 2.24^c	31.34 ± 2.35^c^,^e	< 0.001	< 0.001	< 0.001
Prophylactic clip use	10 (9.35)	1 (0.94)^b	3 (2.77)	0.018	0.627	0.129
Operator experience				0.207	0.530	0.654
Experienced endoscopist	106 (99.07)	99 (93.4)	103 (95.37)
Non-experienced endoscopist	1 (0.93)	7 (6.6)	5 (4.63)
Intraoperative bleeding (mL)	4.18 ± 0.25	4.16 ± 0.29	4.22 ± 0.13	1.806	0.162	0.264
Hospital time (days)	0.96 ± 0.58	0.82 ± 0.44	0.97 ± 0.56	0.114	0.090	2.703

¹High-frequency electroresection vs cold snare polypectomy.

²Cold snare polypectomy vs endoscopic mucosal resection.

³High-frequency electroresection vs endoscopic mucosal resection.

^bP < 0.01 vs high-frequency electroresection group.

^cP < 0.001 vs high-frequency electroresection group.

^eP < 0.001 vs cold snare polypectomy group.

HFE: High-frequency electroresection; CSP: Cold snare polypectomy; EMR: Endoscopic mucosal resection.

Full Size Table

Table 5 Resection rate, n (%)

Parameters	HFE (n = 107)	CSP (n = 106)	EMR (n = 108)	P¹ value	P² value	P³ value
En bloc resection⁴	91 (85.05)	95 (89.62)	77 (71.30)^a^,^e	0.948	< 0.001	0.045
R0 resection⁵	87 (81.31)	65 (61.32)^b	79 (73.14)	0.003	0.195	0.462
R1 resection⁶	20 (18.69)	22 (20.75)	30 (27.78)	2.115	0.693	0.345
Rx resection⁷	17 (15.89)	16 (15.09)	16 (14.81)	2.619	2.862	2.481
Ulcer base diameter one week after treatment (mm)	4.84 ± 1.02	3.19 ± 0.66^c	3.52 ± 0.85^c^,^d	< 0.001	0.006	< 0.001

¹High-frequency electroresection vs cold snare polypectomy.

²Cold snare polypectomy vs endoscopic mucosal resection.

³High-frequency electroresection vs endoscopic mucosal resection.

⁴Defined as a once-piece resection.

⁵Defined as en bloc resection with a histologically negative margin.

⁶Defined as a positive resection margin.

⁷Defined as an unknown resection status.

^aP < 0.05 vs high-frequency electroresection group.

^bP < 0.01 vs high-frequency electroresection group.

^cP < 0.001 vs high-frequency electroresection group.

^dP < 0.01 vs cold snare polypectomy group.

^eP < 0.001 vs cold snare polypectomy group.

HFE: High-frequency electroresection; CSP: Cold snare polypectomy; EMR: Endoscopic mucosal resection.

Full Size Table

Citation: Ji DH, Guan ZA. Evaluation of efficacy and safety of different endoscopic polypectomy techniques for colonic polyps. World J Gastrointest Surg 2025; 17(9): 110347
URL: https://www.wjgnet.com/1948-9366/full/v17/i9/110347.htm
DOI: https://dx.doi.org/10.4240/wjgs.v17.i9.110347