***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND AIMS Small colorectal polyps are encountered frequently and may be incompletely removed during colonoscopy . The optimal technique for removal of small colorectal polyps is uncertain . The aim of this study was to compare the incomplete resection rate ( IRR ) by using EMR or cold snare polypectomy ( CSP ) for the removal of small adenomatous polyps . METHODS This was a prospect i ve r and omized controlled study from a tertiary-care referral center . A total of 358 patients who satisfied the inclusion criteria ( polyp sized 6 - 9 mm ) were r and omized to the EMR ( n = 179 ) and CSP ( n = 179 ) groups , and their polyps were treated with conventional EMR or CSP , respectively . After polypectomy , an additional 5 forceps biopsies were performed at the base and margins of polypectomy sites to assess the presence of residual polyp tissue . The EMR and CSP sample s were compared to assess the IRR . RESULTS Among a total of 525 polyps , 415 ( 79.0 % ) were adenomatous polyps , and 41 ( 16.4 % ) were advanced adenomas . The overall IRR for adenomatous polyps was significantly higher in the CSP group compared with the EMR group ( 18/212 , 8.5 % vs 3/203 , 1.5 % ; P = .001 ) . Logistic regression analysis revealed that the CSP procedure was a stronger risk factor for the IRR ( odds ratio [ OR ] 6.924 ; 95 % confidence interval [ CI ] , 2.098 - 24.393 ; P = .003 ) . In addition , piecemeal resection was the most important risk factor for the IRR ( OR 28.696 ; 95 % CI , 3.620 - 227.497 ; P = .001 ) . The mean procedure time for polypectomy was not significantly different between the EMR and CSP groups ( 5.5 ± 2.7 vs 4.7 ± 3.4 minutes ; P = .410 ) . None of these patients presented with delayed bleeding . There were no severe adverse events related to the biopsies . CONCLUSIONS EMR was significantly superior to CSP for achieving complete endoscopic resection of small colorectal polyps . Patients with piecemeal resection of polyps had a higher risk for incomplete resection . ( Clinical trial registration number : Hongwei-1102 - 12 . ) BACKGROUND AND STUDY AIMS Cold snare polypectomy is an established method for the resection of small colorectal polyps ; however , significant incomplete resection rates still leave room for improvement . We aim ed to assess the efficacy of cold snare endoscopic mucosal resection ( CS-EMR ) , compared with hot snare endoscopic mucosal resection ( HS-EMR ) , for nonpedunculated polyps sized 6 - 10 mm . PATIENTS AND METHODS This study was a dual-center , r and omized , noninferiority trial . Consecutive adult patients with at least one nonpedunculated polyp sized 6 - 10 mm were enrolled . Eligible polyps were r and omized ( 1:1 ) to be treated with either CS-EMR or HS-EMR . Both methods involved submucosal injection of a methylene blue-tinted normal saline solution . The primary noninferiority end point was histological eradication evaluated by postpolypectomy biopsies ( noninferiority margin - 10 % ) . Secondary outcomes included occurrence of intraprocedural bleeding , clinical ly significant postprocedural bleeding , and perforation . RESULTS Among 689 patients screened , 155 patients with 164 eligible polyps were included ( CS-EMR n = 83 , HS-EMR n = 81 ) . The overall rate of histological complete resection was 92.8 % in the CS-EMR group and 96.3 % in the HS-EMR group ( difference 3.5 % ; 95 % confidence interval [ CI ] - 4.15 to 11.56 ) , showing noninferiority of CS-EMR compared with HS-EMR . CS-EMR  was shown to be noninferior both for polyps measuring 6 - 7 mm ( CS-EMR 93.3 % ; HS-EMR 100 % ; 95 % CI - 7.95 to 21.3 ) and those of 8 - 10 mm ( 92.5 % vs. 94.7 % , respectively ; 95 % CI - 7.91 to 13.16 ) . Rates of intraprocedural bleeding were similar between the two groups ( CS-EMR 3.6 % , HS-EMR 1.2 % ; P = 0.30 ) . No clinical ly significant postprocedural bleeding or perforation occurred in either group . CONCLUSIONS CS-EMR appears to be a valuable modification of the st and ard cold snare technique , obviating the need to use diathermy for nonpedunculated colorectal polyps sized 6 - 10 mm BACKGROUND AND AIMS Curability is associated with resection width and depth in polypectomy . We evaluated the resection width and depth achieved with hot snare polypectomy ( HSP ) and cold snare polypectomy ( CSP ) for small colorectal polyps . METHODS In this single-center , prospect i ve , r and omized controlled study , patients with rectal or rectosigmoid polyps ≤10 mm in diameter were treated with HSP or CSP . Resection width was evaluated as mucosal defect size , measured immediately postprocedure and 1 day later . Resection depth was histologically evaluated using obtained specimens . RESULTS Fifty-two patients were enrolled . Mean lesion size was 5.6 mm with HSP ( n = 27 ) and 5.8 mm with CSP ( n = 25 ) . Mean mucosal defect diameter immediately after HSP and CSP was 5.1 mm and 7.5 mm , respectively ( P < .001 ) . The diameter 1 day after the procedure increased by 29 % ( 95 % confidence interval [ CI ] , 17%-41 % ) with HSP and decreased by 25 % ( 95 % CI , 18%-32 % ) with CSP ( P < .001 ) . Muscularis mucosa was obtained similarly with HSP and CSP ( 96 % [ 95 % CI , 82%-99 % ] vs 92 % [ 95 % CI , 75%-98 % ] ; P = .603 ) . Submucosal tissue was obtained significantly more frequently with HSP than with CSP ( 81 % [ 95 % CI , 63%-92 % ] vs 24 % [ 95 % CI , 11%-43 % ] ; P < .001 ) . CONCLUSIONS The resection width immediately after CSP was larger than that after HSP but was significantly smaller at day 1 after resection . Although the resection depth after CSP was more superficial , muscularis mucosa was obtained in most specimens . Thus , CSP has sufficient resection width and depth to enable complete polyp resection and potentially has a superior safety profile than HSP BACKGROUND Both cold-only snare and hot polypectomy snare are used for the removal of small colorectal polyps . OBJECTIVE To compare the outcome of cold snare polypectomy of small colorectal polyps with a snare exclusively design ed as a cold snare versus cold snare polypectomy by using a traditional polypectomy snare . DESIGN Prospect i ve , r and omized , controlled study . SETTING Municipal hospital in Japan . INTERVENTIONS Patients with colorectal polyps 10 mm or smaller in diameter were r and omized to dedicated cold snare ( dedicated cold snare group ) or traditional cold snare ( traditional cold snare group ) . The primary outcome measure was complete resection rates by cold snaring based on pathological examination . Secondary outcomes included bleeding within 2 weeks after polypectomy and identification of submucosal arteries and injured arteries in the resected specimens . RESULTS Seventy-six patients having 210 eligible polyps were r and omized : dedicated cold snare group , N = 37 ( 98 polyps ) and traditional cold snare group , N = 39 ( 112 polyps ) . Patient demographic characteristics including the number , size , and shape of the polyps removed were similar in the 2 groups . The complete resection rate was significantly greater with the dedicated cold than with the traditional cold snare ( 91 % [ 89/98 ] vs 79 % [ 88/112 ] , P = .015 ) , with a marked difference with 8- to 10-mm polyps , both flat and pedunculated . Immediate bleeding and hematochezia rates were similar ( 19 % vs 21 % , P = .86 ; 5.4 % vs 7.7 % , P = .69 ) . No delayed bleeding occurred . Histology demonstrated a similar prevalence of arteries and injured arteries in the submucosa ( 33 % [ 32/96 ] vs 30 % [ 31/104 ] , P = .59 ; 3.1 % [ 3/96 ] vs 6.7 % [ 7/104 ] , P = .24 ) . LIMITATIONS Small sample size , single-center study . CONCLUSION Polypectomy by using a dedicated cold snare result ed in complete polyp removal more often than did cold snaring with a traditional snare , especially polyps 8 to 10 mm in diameter , whether flat or pedunculated . ( CLINICAL TRIAL REGISTRATION NUMBER NCT02036047 . BACKGROUND Cold snare techniques are widely used for removal of diminutive and small colorectal polyps . The influence of resection technique on the effectiveness of polypectomy is unknown . We therefore compared st and ard cold snare polypectomy with a newly described suction pseudopolyp technique , for completeness of excision and for complications . PATIENTS AND METHODS In this single-center study , 112 patients were r and omized to cold snare polypectomy or the suction pseudopolyp technique .  Primary outcome was endoscopic completeness of excision . Consensus regarding the endoscopic assessment of completeness of excision was st and ardized and aided by chromoendoscopy . Secondary outcomes included : completeness of histological excision , polyp " fly away " and retrieval rates , early bleeding ( 48 hours ) , delayed bleeding ( 2 weeks ) , and perforation . RESULTS 148 polyps were removed , with size range 3 - 7 mm , 60 % in the left colon , and 90 % being sessile . Regarding completeness of excision ( with uncertain findings omitted ) : endoscopically , this was higher with the suction pseudopolyp technique compared with cold snare polypectomy but not statistically significantly so ( 73/74 [ 98.6 % ] vs. 63/68 [ 92.6 % ] ; P = 0.08 ) . A trend towards a higher complete histological excision rate with the suction pseudopolyp technique was also not statistically significant ( 45/59 [ 76.3 % ] vs. 37/58 [ 63.8 % ] ; P = 0.14 ) . Polyp retrieval rate was not significantly different ( suction 68/76 [ 89.5 % ] vs. cold snare 64/72 [ 88.9 % ] ; P = 0.91 ) . No perforation or bleeding requiring hemostasis occurred in either group . CONCLUSION In this study both polypectomy techniques were found to be safe and highly effective , but further large multicenter trials are required . Clinical trial registration at www . clinical trials.gov : NCT02208401 BACKGROUND The bleeding risk after cold snare polypectomy in anticoagulated patients is not known . OBJECTIVE To compare the bleeding risk after cold snare polypectomy or conventional polypectomy for small colorectal polyps in anticoagulated patients . DESIGN Prospect i ve r and omized controlled study . SETTING Municipal hospital in Japan . INTERVENTIONS Anticoagulated patients with colorectal polyps up to 10 mm in diameter were enrolled . Patients were r and omized to polypectomy with either cold snare technique ( Cold group ) or conventional polypectomy ( Conventional group ) without discontinuation of warfarin .  The primary outcome measure was delayed bleeding ( ie , requiring endoscopic intervention within 2 weeks after polypectomy ) . Secondary outcome measures were immediate bleeding and retrieval rate of colorectal polyps . RESULTS Seventy patients were r and omized ( 159 polyps ) : Cold group ( n = 35 , 78 polyps ) and Conventional group ( n = 35 ; 81 polyps ) . The patients ' demographic characteristics including international normalized ratio and the number , size , and shape of polyps removed were similar between the 2 techniques . Immediate bleeding during the procedure was more common with conventional polypectomy ( 23 % [ 8/35 ] ) compared with cold polypectomy ( 5.7 % [ 2/35 ] ) ( P = .042 ) . No delayed bleeding occurred in the Cold group , whereas 5 patients ( 14 % ) required endoscopic hemostasis in the Conventional group ( P = .027 ) . Complete polyp retrieval rates were identical ( 94 % [ 73/78 ] vs 93 % [ 75/81 ] ) . The presence of histologically demonstrated injured arteries in the submucosal layer with cold snare 
    Output:
    
Conclusions : CSP and HSP may result in the same complete resection rates for polyps ≤10 mm .