Comparison of thin vs. thick wire snares for cold-snare polypectomy

Whether using thin-wire or thick-wire snares, cold-snare polypectomy is equally effective and safe for removing small colorectal polyps.

The effectiveness of thin vs. thick-wire snares in cold-snare polypectomy (CSP) for the resection of small colorectal polyps (≤10 mm) has been debated. This meta-analysis aimed to clarify which snare type offers better outcomes with fewer adverse effects.

Data from two observational studies and four randomized controlled trials involving 1,316 patients and 1,679 polyps (≧1 and ≦10 mm) treated with thin-wire or thick-wire snares were incorporated. The key outcome included complete resection (CR) rate while secondary outcomes included polyp retrieval, intraprocedural or post-polypectomy bleeding, deep mural injury, procedure time, patient discomfort, and total sedation.  Investigators used random-effects models to calculate risk ratios, assessed bias, rated evidence certainty, and checked for publication bias.

No significant differences were found between thin-wire and thick-wire snares for CR rates in RCTs (92.1% vs. 87.7%)  or observational studies (78.1% vs. 79.6%). Both snare types showed similar results for polyp retrieval and intraprocedural bleeding. No instances of delayed bleeding or perforation were reported.

CSP is safe and effective for endoscopic resection of small colorectal polyps, regardless of snare type.