We review our approach to resection of colorectal polyps <20 mm in size. Careful inspection of all lesions is appropriate to assess the type of lesion (adenoma vs serrated) and evaluate the risk of cancer, which is highly associated with lesion size. Polyp resection is in the midst of a “cold revolution,” particularly for lesions <10 mm in size, but also for some larger lesions. Cold forceps are sometimes appropriate for 1- to 2-mm lesions that can be engulfed in one bite, but we use cold snaring for almost the entire set of lesions <10 mm. For 10- to 19-mm conventional adenomas, we rely primarily on hot snare resection. Endoscopic mucosal resection (EMR), preferably en bloc, is appropriate for bulky nongranular conventional adenomas and nongranular adenomas with depression in this size range. For sessile serrated polyps 10 to 19 mm in size our approaches differ to some extent, with one of us using primarily “cold EMR,” and the other using primarily hot EMR technique.

我们回顾了切除尺寸小于20毫米的结直肠息肉的方法。仔细检查所有病变适合评估病变类型（腺瘤与锯齿状）并评估癌症风险，这与病变的大小高度相关。息肉切除术处于“冷循环”之中，特别是对于<10 mm大小的病变，也适用于一些较大的病变。有时，冷钳适合1到2毫米的病灶，可被一口吞噬，但是对于几乎所有小于10毫米的病灶，我们都使用冷钳法。对于10至19毫米的常规腺瘤，我们主要依靠热圈套切除术。内窥镜黏膜切除术（EMR），最好是整块术，适合于该尺寸范围内的大块非颗粒性常规腺瘤和凹陷性非颗粒性腺瘤。