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Cold snaring of diminutive polyps is now well established as safe and effective, but there are doubts about its appropriate use for 6-9-mm (small) polyps because of recent evidence suggesting reduced efficacy of cold snaring without injection compared with hot endoscopic mucosal resection (EMR) using Endocut.
In the first randomized trial of cold versus hot EMR for removal of small polyps, researchers at two centers in Greece treated over 160 small polyps with either hot EMR — utilizing several snares with Endocut Q — or cold EMR — utilizing both standard and dedicated snares. Residual polyp was identified by cold biopsy of the margin in four quadrants and a separate sample from the base. Saline was used for injection (with methylene blue).
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