title: Efficacy and adverse events of cold vs hot polypectomy: A meta-analysis.
abstract: OBJECTIVE
  To compare previously reported randomized controlled studies (RCTs) of cold and hot polypectomy, we systematically reviewed and clarify the utility of cold polypectomy over hot with respect to efficacy and adverse events.
  
  
  METHODS
  A meta-analysis was conducted to evaluate the predominance of cold and hot polypectomy for removing colon polyps. Published articles and abstracts from worldwide conferences were searched using the keywords "cold polypectomy". RCTs that compared either or both the effects or adverse events of cold polypectomy with those of hot polypectomy were collected. The patients' demographics, endoscopic procedures, No. of examined lesions, lesion size, macroscopic and histologic findings, rates of incomplete resection, bleeding amount, perforation, and length of procedure were extracted from each study. A forest plot analysis was used to verify the relative strength of the effects and adverse events of each procedure. A funnel plot was generated to assess the possibility of publication bias.
  
  
  RESULTS
  Ultimately, six RCTs were selected. No significant differences were noted in the average lesion size (less than 10 mm) between the cold and hot polypectomy groups in each study. Further, the rates of complete resection and adverse events, including delayed bleeding, did not differ markedly between cold and hot polypectomy. The average procedural time in the cold polypectomy group was significantly shorter than in the hot polypectomy group.
  
  
  CONCLUSIONS
  Cold polypectomy is a time-saving procedure for removing small polyps with markedly similar curability and safety to hot polypectomy.
authors.affiliation: Mikihiro Fujiya, Hiroki Sato, Nobuhiro Ueno, Aki Sakatani, Kazuyuki Tanaka, Tatsuya Dokoshi, Shugo Fujibayashi, Yoshiki Nomura, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Yutaka Kohgo, Division of Gastroenterology and Hematological Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Fujiya
authors.affiliation: Mikihiro Fujiya, Hiroki Sato, Nobuhiro Ueno, Aki Sakatani, Kazuyuki Tanaka, Tatsuya Dokoshi, Shugo Fujibayashi, Yoshiki Nomura, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Yutaka Kohgo, Division of Gastroenterology and Hematological Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sato
authors.affiliation: Mikihiro Fujiya, Hiroki Sato, Nobuhiro Ueno, Aki Sakatani, Kazuyuki Tanaka, Tatsuya Dokoshi, Shugo Fujibayashi, Yoshiki Nomura, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Yutaka Kohgo, Division of Gastroenterology and Hematological Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ueno
authors.affiliation: Mikihiro Fujiya, Hiroki Sato, Nobuhiro Ueno, Aki Sakatani, Kazuyuki Tanaka, Tatsuya Dokoshi, Shugo Fujibayashi, Yoshiki Nomura, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Yutaka Kohgo, Division of Gastroenterology and Hematological Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Sakatani
authors.affiliation: Mikihiro Fujiya, Hiroki Sato, Nobuhiro Ueno, Aki Sakatani, Kazuyuki Tanaka, Tatsuya Dokoshi, Shugo Fujibayashi, Yoshiki Nomura, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Yutaka Kohgo, Division of Gastroenterology and Hematological Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Mikihiro Fujiya, Hiroki Sato, Nobuhiro Ueno, Aki Sakatani, Kazuyuki Tanaka, Tatsuya Dokoshi, Shugo Fujibayashi, Yoshiki Nomura, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Yutaka Kohgo, Division of Gastroenterology and Hematological Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Dokoshi
authors.affiliation: Mikihiro Fujiya, Hiroki Sato, Nobuhiro Ueno, Aki Sakatani, Kazuyuki Tanaka, Tatsuya Dokoshi, Shugo Fujibayashi, Yoshiki Nomura, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Yutaka Kohgo, Division of Gastroenterology and Hematological Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Shugo
authors.initials: S
authors.lastname: Fujibayashi
authors.affiliation: Mikihiro Fujiya, Hiroki Sato, Nobuhiro Ueno, Aki Sakatani, Kazuyuki Tanaka, Tatsuya Dokoshi, Shugo Fujibayashi, Yoshiki Nomura, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Yutaka Kohgo, Division of Gastroenterology and Hematological Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Nomura
authors.affiliation: Mikihiro Fujiya, Hiroki Sato, Nobuhiro Ueno, Aki Sakatani, Kazuyuki Tanaka, Tatsuya Dokoshi, Shugo Fujibayashi, Yoshiki Nomura, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Yutaka Kohgo, Division of Gastroenterology and Hematological Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Kashima
authors.affiliation: Mikihiro Fujiya, Hiroki Sato, Nobuhiro Ueno, Aki Sakatani, Kazuyuki Tanaka, Tatsuya Dokoshi, Shugo Fujibayashi, Yoshiki Nomura, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Yutaka Kohgo, Division of Gastroenterology and Hematological Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Gotoh
authors.affiliation: Mikihiro Fujiya, Hiroki Sato, Nobuhiro Ueno, Aki Sakatani, Kazuyuki Tanaka, Tatsuya Dokoshi, Shugo Fujibayashi, Yoshiki Nomura, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Yutaka Kohgo, Division of Gastroenterology and Hematological Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Junpei
authors.initials: J
authors.lastname: Sasajima
authors.affiliation: Mikihiro Fujiya, Hiroki Sato, Nobuhiro Ueno, Aki Sakatani, Kazuyuki Tanaka, Tatsuya Dokoshi, Shugo Fujibayashi, Yoshiki Nomura, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Yutaka Kohgo, Division of Gastroenterology and Hematological Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Moriichi
authors.affiliation: Mikihiro Fujiya, Hiroki Sato, Nobuhiro Ueno, Aki Sakatani, Kazuyuki Tanaka, Tatsuya Dokoshi, Shugo Fujibayashi, Yoshiki Nomura, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Yutaka Kohgo, Division of Gastroenterology and Hematological Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Watari
authors.affiliation: Mikihiro Fujiya, Hiroki Sato, Nobuhiro Ueno, Aki Sakatani, Kazuyuki Tanaka, Tatsuya Dokoshi, Shugo Fujibayashi, Yoshiki Nomura, Shin Kashima, Takuma Gotoh, Junpei Sasajima, Kentaro Moriichi, Yutaka Kohgo, Division of Gastroenterology and Hematological Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kohgo
mesh_terms: D003111:Colonic Polyps / Q000601:surgery*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D000069916:Endoscopic Mucosal Resection / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D061646:Operative Time; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D016896:Treatment Outcome
keywords: Bleeding; Cold polypectomy; Colon adenoma; Colon neoplasm; Conventional polypectomy; Endoscopic mucosal resection; Hot polypectomy