Hot Snare vs. Hot EMR for Small Colorectal Polyps

Some recent data suggest that use of endoscopic mucosal resection (EMR) should be extended to small colorectal polyps.

In a randomized trial comparing standard hot snaring with EMR of small polyps (5–9 mm), EMR was performed with 1 to 3 milliliters of saline solution including 1:10,000 epinephrine, and coagulation in both arms was performed using Endocut. After resection, four biopsy specimens were taken from the edges of the lesion. Approximately 380 polyps in 270 patients were resected.

The complete resection rate was similar with hot snaring and EMR (88% and 93%, respectively). Incomplete resection rates varied from 6% to 13% among five endoscopists but did not constitute a statistically significant difference. Among 353 polyps analyzed fo…