From the Research
I recommend resecting the polyp using cold snare polypectomy (CSP) technique for polyps ≤10 mm and scheduling a surveillance colonoscopy in 3 years, as CSP has been shown to be effective and safe for small polyps, with lower risks of delayed bleeding and perforation compared to hot snare polypectomy 1. For larger polyps (>10 mm), endoscopic mucosal resection (EMR) may be considered, but recent studies suggest that CSP can be safely used for polyps up to 20 mm in size, with low complication rates and recurrence rates ranging from 5-18% 2, 3. The choice of resection technique depends on the size, location, and histology of the polyp, as well as the patient's overall health and medical history. Some key points to consider when deciding on the resection technique include:
- The size of the polyp: CSP is generally recommended for polyps ≤10 mm, while EMR may be considered for larger polyps 2, 3.
- The location of the polyp: Polyps in difficult-to-reach locations may require EMR or other advanced resection techniques 4.
- The histology of the polyp: Serrated polyps may be more prone to incomplete resection and may require more frequent surveillance 5.
- The patient's medical history: Patients with bleeding disorders or taking antithrombotic agents may be at higher risk for bleeding complications and may benefit from CSP 4, 1. The surveillance interval of 3 years is based on the size, number, and histology of polyps found during the initial colonoscopy, as well as the patient's overall risk of colorectal cancer 2, 3. If the polyp is advanced (>10 mm, villous features, or high-grade dysplasia), or if multiple polyps are present, a shorter surveillance interval may be necessary 2, 3. If pathology reveals adenocarcinoma or sessile serrated lesions, the surveillance interval may need to be adjusted based on the patient's individual risk factors and medical history 2, 3.