Bleeding risk and prevention after colorectal polypectomy: What differs between cold and hot resection?

Table 2 Main bleeding risk factors and practical considerations after cold resection

Risk domain	Main risk factors	Suggested approach
Patient-related	Antithrombotic therapy	Assess bleeding risk and anticipated long-term oncologic benefit before selecting the resection technique
Lesion-related	Pedunculated morphology, larger size, rectal location, larger wound size	Restrict cold resection to appropriate indications. Use caution in pedunculated and larger lesions; when adenomatous lesions are treated with cold resection, closer post-resection surveillance may be appropriate
Procedure-related	Intraprocedural hematoma, persistent immediate bleeding, large cold defects	Routine prophylactic hemostasis is unnecessary in most cases, but selected high-risk defects may warrant endoscopic treatment