Abstract
Colorectal cancers arise from conventional adenomas via the suppressor pathway that is initiated with a mutation of the APC gene, the so-called “adenoma-carcinoma sequence”. Adequate colonoscopic polypectomy remains as one of the most important interventions during screening colonoscopy in the prevention of colorectal cancer progression and subsequently lowers mortality from colorectal cancer. Actually, most of the detected polyps are diminutive polyps (≤5mm) and small polyps (<10mm) in clinical practice. Recently, there have been studies reporting the safety and efficacy of cold polypectomy technique which involves no electrocautery for diminutive and small polyps and this technique has become widely performed especially in Western countries. Cold forceps polypectomy using a jumbo biopsy forceps designed with a greater capacity for removing larger tissue samples and cold snare polypectomy with a stiff mini-snare are preferred for diminutive polyps and small polyps, respectively. Cold polypectomy technique is a simple and quick technique allowing complete resection of most diminutive and small polyps provided that the polypectomy site is assessed using narrow band imaging with magnification after water-jet irrigation of the targeted area for complete removal.
