Efficacy and safety of cold snare and hot snare endoscopic mucosal resection in the removal of colorectal polyps: a systematic review and meta-analysis based on RCT studies.

Overall procedural time showed no significant difference between groups (MD = -2.30 min, 95% CI: -8.69 to 4.09, p = 0.48).

Subgroup analysis revealed C-EMR significantly shortened procedural time for polyps ≤20 mm (MD = -11.53 min, p = 0.004), while H-EMR was faster for polyps >20 mm (MD = 3.89 min, p < 0.001; subgroup interaction p < 0.001).

No significant differences were found in complete resection, en bloc resection, technical success or intraprocedural bleeding rates.

C-EMR had a trend toward higher postoperative recurrence, approaching significance in polyps >20 mm ( p = 0.08).