***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 
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    ***EXAMPLES*** 
    Input: 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 AND STUDY AIMS Narrow-b and imaging ( NBI ) has shown promising results in discriminating adenomatous from non-adenomatous colonic polyps . In patients with small polyps ( < 10 mm ) , the application of NBI within a " resect and discard " strategy , might allow post-polypectomy surveillance intervals to be determined independently from histopathology . The aim of the present study was to assess the feasibility and safety of this approach in routine clinical practice . PATIENTS AND METHODS Consecutive colonoscopy out patients with one or more polyps smaller than 10 mm were prospect ively included . Each polyp was categorized by the endoscopist as adenoma or non-adenoma according to simplified NBI criteria , and future post-polypectomy surveillance interval was assigned accordingly . Following histopathology ,  post-polypectomy surveillance interval was subsequently re-assigned , and the accordance between endoscopy- and histology-directed surveillance  strategies was calculated . RESULTS Among 942 colonoscopy patients , 286 ( 30.4 % ) with only small polyps were included . In total , 511 small polyps were evaluated ; 350 ( 68.5 % ) were adenomas and 18 of these ( 5.1 % ) had histologic features of advanced neoplasia . For the in vivo diagnosis of adenoma , NBI sensitivity , specificity , accuracy , and positive and negative likelihood ratios were 94.9 % , 65.8 % , 85.7 % , 2.80 , and 0.08 , respectively . The endoscopy-directed surveillance strategy was in accordance with the  histology-directed strategy in 237 of 286 patients ( 82.9 % ) . In 9.8 % and 7.3 % patients , the endoscopy-directed approach would have result ed in early and delayed surveillance , respectively . CONCLUSIONS The resect and discard strategy seems to be a viable , safe , and cost-effective approach for the management of patients with small polyps . However , caution in the application of the strategy should be advocated for patients with polyps 6 - 9 mm in size and those with right-sided lesions , due to their malignant potential . The study was registered on Clinical trials.gov ( NCT01462123 ) BACKGROUND Polypectomy techniques vary in clinical practice . The aim of this study was to determine patterns of polypectomy practice s in a r and om sample of gastroenterologists . METHODS A total of 300 gastroenterologists were selected r and omly from the membership directory of a professional society . They were asked to complete a st and ardized survey by telephone , electronic mail , or facsimile . RESULTS The offices of 285 physicians were contacted successfully . A total of 189 ( 63 % ) chose to participate . 152 ( 80 % ) of these physicians were in private practice , and 37 ( 20 % ) were in academic practice . The mean number of years in practice was 15.5 ( range 1 - 46 years ) . Forceps techniques ( cold or hot ) dominated other polypectomy methods for polyps 1 to 3 mm in size ( p < 0.0001 ) , whereas electrosurgical snare resection was dominate for polyps 7 to 9 mm in diameter ( p < 0.0001 ) . No method of polypectomy was significantly more likely to be used for polyps 4 to 6 mm in size . The proportion of physicians who had used  dye spraying  was 8.5 % ; detachable snares , 20.1 % ; clips , 20.1 % ; and submucosal saline solution injection , 82 % . Of those who had used submucosal saline solution injection , 29.7 % had no rules for its use , and , in the remainder , there was marked variation regarding the criteria . For polyp stalks greater than 1 cm in diameter , 69 % used no method to prevent bleeding . Of those who did use preventive techniques , 76 % used  epinephrine injection . The electrosurgical current used for polypectomy was pure coagulation in 46 % , blend in 46 % , and pure-cut in 3 % ; 4 % varied the current . CONCLUSIONS At present , polypectomy technique among clinical gastroenterologists is highly variable . Some newer ancillary techniques have had extremely limited use thus far BACKGROUND AND STUDY AIMS Cold biopsy forceps polypectomy ( CBP ) is commonly used for the removal of diminutive polyps ; however , evidence for the efficacy of CBP is lacking . The aim of this study was to evaluate the adequacy of resection of diminutive polyps and to identify predictors for complete resection using CBP . PATIENTS AND METHODS This was a prospect i ve study from a tertiary referral hospital in Korea . A total of 196 patients were screened , and 65 patients with diminutive polyps were enrolled .  CBP was used to resect diminutive polyps until no polyp was visible by chromoendoscopy using indigo carmine spray . Each polyp base was then resected using endoscopic mucosal resection ( EMR ) with a 1 - 3-mm free margin . CBP and EMR specimens were sent to the histopathology department for the evaluation of the completeness of the resection . Cross sections of the EMR specimens made at 1-mm intervals were examined by a pathologist . RESULTS A total of 86 diminutive polyps were available for assessment . Overall , 90.7 % ( 78/86 ) of the diminutive polyps were completely resected using CBP ( 95%CI 84.6 - 96.8 % ) . The complete resection rate for all diminutive adenomas was 92.3 % ( 60/65 ; 95%CI 85.8 - 98.8 % ) and for 1 - 3-mm adenomas 100 % ( 95%CI 81.5 - 100 % ) . Polyp size , histology , and location , and number of biopsies were not different between the complete and incomplete resection groups . CONCLUSIONS In this small study approximately 90 % of all diminutive polyps and 100 % of 1 - 3-mm adenomatous polyps were completely resected using CBP and chromoendoscopy . CBP appears to be adequate for the resection of the majority of diminutive polyps , especially small sized adenomas ( ≤ 3 mm ) if no residual tissue is visible by chromoendoscopy BACKGROUND Polypectomy with cold biopsy forceps is a frequently used technique for removal of small , sessile , colorectal polyps . Jumbo forceps may lead to more effective polypectomy because of the larger size of the forceps cup . OBJECTIVE To evaluate the efficiency of cold jumbo biopsy forceps compared with st and ard forceps for polypectomy of small , sessile , colorectal polyps . DESIGN R and omized , controlled trial . SETTING Outpatient endoscopy center . PATIENTS This study involved 140 patients found to have at least one eligible polyp defined as a sessile polyp measuring ≤6 mm . INTERVENTION Polypectomy with cold biopsy forceps . MAIN OUTCOME MEASUREMENTS Complete visual polyp eradication with one forceps bite . RESULTS In 140 patients , a total of 305 eligible polyps were detected ( 151 removed with jumbo forceps and 154 with st and ard forceps ) . Complete visual eradication of the polyp with one forceps bite was achieved in 78.8 % of the jumbo forceps group and 50.7 % of the st and ard forceps group ( P < .0001 ) . Biopsies from the polypectomy sites of adenomatous polyps thought to be visually completely eradicated with one bite showed a trend toward a higher complete histologic eradication rate with the jumbo forceps ( 82.4 % ) compared with the st and ard forceps ( 77.4 % ) , but the difference did not reach statistical significance ( P = .62 ) . The withdrawal time for visual inspection of the colon and time to perform polypectomies were significantly shorter in the jumbo forceps group ( mean 21.43 vs 18.23 minutes ; P = .02 ) . LIMITATIONS Lack of blinding to the type of forceps used . CONCLUSION The jumbo biopsy forceps is superior to the st and ard forceps in removing small , sessile polyps . ( CLINICAL TRIAL REGISTRATION NUMBER NCT00855790 . ) OBJECTIVES : There are few data on cold snare polypectomy ( CSP ) in direct comparison with cold forceps polypectomy ( CFP ) for  colonoscopic resection of diminutive colorectal polyps ( DCPs ; ≤5 mm ) . The primary aim of this study was to compare the histologic polyp eradication rate of CSP with that of CFP using double-biopsy technique . METHODS : This was a r and omized controlled trial at a single academic hospital . Of the 165 patients invited , 54 consecutive patients having 117 eligible polyps were enrolled in this study . To evaluate histologic eradication of polyps , two or more additional biopsies were taken from the base and edges of the polypectomy site . RESULTS : The mean size of polyps was 3.66 mm ( ±1.13 ) . Most polyps evaluated were tubular adenomas ( 69.9 % ) . The rate of histologic eradication was significantly higher in the CSP group than in the CFP group ( 93.2 % vs. 75.9 % , P=0.009 ) . The time taken for polypectomy was significantly shorter in the CSP group ( 14.29 vs. 22.03 s , P<0.001 ) . Failure of tissue retrieval was noted in 6.8 % of polyps resected by CSP . Multivariate analysis revealed that the method of polypectomy ( CFP ) and the polyp size ( ≥4 mm ) were independent predictors associated with incomplete histologic eradication ( odds ratio ( OR ) 4.750 ( 95 % confidence interval ( CI ) : 1.459–15.466 ) , OR 4.375 ( 95 % CI : 1.345–14.235 ) ; all P<0.05 , respectively ) . CONCLUSIONS : CSP is superior to CFP for the endoscopic removal of DCPs with regard to completeness of polypectomy  . CSP technique should be considered the primary method for endoscopic treatment of polyps in the 4–5-mm size range ( Clinical Trials.gov number : NCT01646242 ) BACKGROUND AND STUDY AIMS Cold biopsy forceps polypectomy ( CBP ) is often used for the removal of diminutive polyps . The efficacy of the technique has not been thoroughly assessed . The aim of this study was to prospect ively assess the efficacy of CBP for removing diminutive polyps . PATIENTS AND METHODS This was a prospect i ve study from St Vincent 's Hospital , a tertiary referral hospital 
    Output:
    
Conclusions Dedicated CSP was shown to be superior to other cold polypectomy techniques in terms of complete histological eradication .
Cold polypectomy using a dedicated snare can be recommended for the removal of diminutive colorectal polyps