Adoption of Optimal Small (6–9 mm) Colorectal Polyp Resection Technique Over Time

Larissa Muething, Bill Quach, Derek E. Smith, Dexiang Gao, Joshua A. Smith, Robert T. Simril, Amanda Tompkins, Jeannine Espinoza, Michelle L. Cowan, Hazem Hammad, Sachin Wani, Swati G. Patel

Research output: Contribution to journalArticlepeer-review


Background: Cold snare polypectomy (CSP) is the preferred resection technique for small (6–9 mm) polyps due to lower rate of incomplete resection compared to cold forceps polypectomy (CFP) and improved safety profile over hot snare polypectomy (HSP). Aims: To describe resection techniques for small (6–9 mm) polyps and determine factors associated with sub-optimal technique. Methods: This was retrospective cohort study of colonoscopies performed by gastroenterological and surgical endoscopists from 2012 to 2019 where at least one 6–9 mm polyp was removed. Patient, provider, and procedure characteristics were collected. Univariate and multivariate regression analyses were performed to determine factors associated with sub-optimal technique. Results: In total, 773 colonoscopies where 1,360 6–9 mm polyps removed by 21 endoscopists were included. CSP was used for 1,122 (82.5%), CFP for 61 (4.5%), and HSP for 177 (13.0%). Surgeon specialty was associated with CFP use (aOR 7.81; 95% CI 3.02–20.16). Polyp location in left colon (aOR 1.65; 95% CI 1.17–2.33) and pedunculated morphology (aOR 12.76; 95% CI 7.24–22.50) were associated with HSP. There was a significant increase in overall CSP use from 30.4% in 2012 to 96.8% in 2019. Conclusions: 82.5% of all 6–9 mm polyps removed from 2012 to 2019 were removed using a cold snare with significant increase in CSP from 2012 to 2019. Differences in how optimal technique was adopted over time based on specialty highlight the need for standardized practice guidelines and quality monitoring.

Original languageEnglish
Pages (from-to)240-251
Number of pages12
JournalDigestive diseases and sciences
Issue number1
StatePublished - Jan 2023


  • Biopsy forceps
  • Colonoscopy
  • Colorectal cancer
  • Colorectal polyps
  • Electrocautery
  • Polypectomy
  • Snare


Dive into the research topics of 'Adoption of Optimal Small (6–9 mm) Colorectal Polyp Resection Technique Over Time'. Together they form a unique fingerprint.

Cite this