Efficacy and safety of cold snare polypectomy using a spike snare for duodenal adenomas : an observational study

Background: Duodenal adenomas are precursors to adenocarcinoma and are generally managed with resection.Cold snare polypectomy (CSP) has gained attention as a safer alternative to conventional endoscopic mucosal resection for duodenal lesions due to the thin duodenal wall.This study aimed to assess the efficacy and safety of CSP using a novel spike snare for duodenal low-grade dysplasia (LGD). Materials and Methods:This study retrospectively analyzed 13 patients diagnosed with duodenal LGD who underwent CSP using a 15-mm spike snare between August 4, 2025 and February 23, 2026.In some cases, electrocautery was applied without submucosal injection.Procedure success rates, en bloc resection rates, and complications, including immediate and delayed bleeding or perforation, were assessed.Results: A total of 13 patients (9 males and 4 females; mean age 58.2 years) were included.Lesions were located in the superior duodenal angle or the second portion of the duodenum, with a mean size of 0.90.2cm (range: 0.5-1.0cm).All lesions were successfully removed en bloc (100%).Hemostasis was achieved in all cases during the procedure using clips or electrocautery if needed.No immediate or delayed complications, such as perforation or significant bleeding requiring intervention, were observed.Follow-up endoscopy performed 2 months after the procedure showed no recurrence in any patient.Conclusion: CSP using a spike snare is considered a safe and effective technique for resecting small duodenal adenomas.The spike snare may facilitate easier tissue capture and en bloc resection without increasing the risk of complications.