Newly found polyps after removal of diminutive colorectal polyps: cold snare polypectomy vs. conventional polypectomy

Background: There are limited data comparing polyp recurrence between cold snare polypectomy (CSP) and conventional polypectomy (CP) for colonoscopic resection of diminutive colorectal polyps. Objective: To evaluate the rate of newly found polyp after CSP and CP and the predictive factors. Methods: This was a retrospective case-control study. Patients undergoing CSP or CP for diminutive colorectal polyps (<8mm) included in the previous study were enrolled. New polyps were defined as polyps found at follow-up colonoscopy within 3 years after CSP or CP. Predictive factors for newly found polyps were assessed by multivariate analysis using logistic regression. Results: A total of 72 patients (female 22, mean age 68) with 184 polyps were included. 89 polyps (mean size + SD, 5.3+2 mm) were resected with CSP and 95 polyps (mean size 5.5+6 mm) were resected with CP. There were each 12 new polyps following both CSP and CP. The rate of new polyps was similar (i.e., CSP vs. CP: (13.5% vs. 12.6%, P=0.86). Multivariate analysis revealed that the removal of >4 polyps was an independent predictor associated with new polyps (odds ratio: 7.8, 95% confidence interval: 2.1-32, P=0.0022). Conclusions: The recurrence of polyps (e.g., a likely measure of completeness of polypectomy) was similar after CSP and CP for the endoscopic removal of diminutive polyps. Because of the simplicity and lower complications CSP is the preferable method for resection of diminutive polyps.