Abstract:Objective To observe the application and efficacy of cold snare polypectomy (CSP) in the clinical treatment of 5-10 mm flat colorectal polyps in elderly patients. Methods Elderly patients with flat colorectal polyps measuring 5-10 mm in diameter, detected through colonoscopy and admitted to the Department of Gastroenterology at Nanjing Jiangbei Hospital and the Fourth Affiliated Hospital of Nanjing Medical University from August 2023 to April 2025, were selected. They were randomly divided into three groups using a random number table: the CSP group, the hot snare polypectomy (HSP) group, and the HSP with submucosal injection group (combined group), with 40 cases in each group. The general data, polyp resection time, one-time complete resection rate, 1-year recurrence rate, as well as incidence intraoperative bleeding / perforation and delayed postoperative bleeding / perforation were compared among the three groups. Results There was no statistically significant difference in general data, complete resection rate, recurrence rate after one year, intraoperative bleeding and overall complications among the three groups (P> 0.05). The polyp removal time for the combined group was (4.01±0.82) min, for the CSP group was (2.04±0.53) min, and for the HSP group was (2.17 ± 0.43) min. The difference in polyp removal time among the three groups was statistically significant (F=129.405, P<0.01). The polyp removal time of the combined group was longer than that of the CSP group and the HSP group (P<0.05), while there was no statistically significant difference between the CSP group and the HSP group (P>0.05). No statistically significant difference was observed in the incidence of intraoperative complications among the three groups (P>0.05). Delayed postoperative bleeding occurred in 0, 2, and 5 cases in the CSP group, HSP group, and combined group, respectively, and delayed postoperative perforation occurred in 0, 0, and 1 case, respectively. The difference in the total incidence of postoperative complications among the CSP group, HSP group, and combined group was statistically significant [0 vs 5.0% vs 15.0%, χ²=7.500, P=0.024]. Conclusion CSP is safe and effective in treating 5-10 mm flat colorectal polyps in elderly patients, with results comparable to HSP.