Cold Versus Hot Snare Endoscopic Mucosal Resection for Intermediate-Size Flat Nonpedunculated Colorectal Polyps

This multicenter, prospective, randomized, non-inferiority trial aimed to compare the efficacy and safety of cold snare endoscopic mucosal resection (CS-EMR) and hot snare endoscopic mucosal resection (HS-EMR) for resection of intermediate-size (10-20 mm) flat nonpedunculated colorectal polyps.

Inclusion Criteria: 1. Subjects aged 18-75 years, irrespective of gender; 2. Flat sessile colorectal polyps confirmed by colonoscopy, classified as Paris classification 0-Is or 0-IIa, with a measured diameter ranging from 10 to 20 mm; 3. Subjects voluntarily agree to receive endoscopic treatment and sign written informed consent. Exclusion Criteria: 1. Colonoscopic findings suggestive of submucosal invasion or malignant transformation of colorectal polyps; 2. Previous history of colorectal surgery; 3. Previous history of inflammatory bowel disease, familial adenomatous polyposis, or colorectal cancer; 4. Failure to discontinue anticoagulant and antiplatelet medications for a minimum of 1 week prior to the procedure; 5. Known coagulation disorders or bleeding diathesis; 6. Pregnant or breastfeeding women; 7. Patients complicated with malignant tumors, severe cardiovascular and cerebrovascular diseases, liver cirrhosis, chronic kidney disease, or other severe comorbidities that preclude tolerance to endoscopic resection.