The Resection Ability of Low‐power Pure‐cut Hot Snare Polypectomy for Nonpedunculated Colorectal Polyps Smaller Than 10 mm: A Single‐center Prospective Study

Objectives Small colorectal polyps sometimes include high‐grade adenomas or carcinomas that require endoscopic resection with electrocautery. Recent studies have reported the usefulness of low‐power pure‐cut hot snare polypectomy (LPPC‐HSP) as a less invasive technique. However, the actual resection depth of LPPC‐HSP has not been fully investigated. Therefore, this study aimed to evaluate the resection ability of LPPC‐HSP for small colorectal polyps. Methods In this single‐arm prospective observational study, patients scheduled to undergo LPPC‐HSP for nonpedunculated colorectal polyps smaller than 10 mm were enrolled. The primary outcome was the rate of sufficient vertical R0 resection (SVR0), defined as an R0 resection with a sufficient submucosal layer beneath the whole lesion. Results A total of 95 patients with 150 lesions were included. The en bloc and R0 resection rates were 100% and 83%, respectively. The SVR0 rate was 76.7% (90% confidence interval: 70.3%–82.2%). All specimens contained the muscularis mucosa, and 132 lesions (88%) contained submucosal tissue. The median maximum submucosal thickness was 1331 µm (interquartile range, 736–2044 µm). No bleeding, perforation, or other serious adverse events were observed. Conclusions LPPC‐HSP demonstrated acceptable vertical resection capability. LPPC‐HSP may be applicable for colorectal polyps smaller than 10 mm with potential malignancy, providing resection depth comparable to that of conventional electrocautery‐based methods. Trial Registration : University Hospital Medical Network Clinical Trials Registry: UMIN000054732