Hoskins BJ, Ng K, RexDK. J Pediatr GastroenterolNutr. 2025;81:162‐166. Open Access! Is it time to revisit the need for pediatric polypectomy guidelines?

This commentary/review makes a number of useful points:

• In adults, there have been important changes in recommendations. Guidelines recommend “cold snare polypectomy (CSP) for small and diminutive polyps (<10 mm) due to its favorable safety profile compared to electrocautery techniques.²”
• “The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition provides position papers for polyposis syndromes from 2019, including familial adenomatous polyposis (FAP), Peutz–Jeghers syndrome (PJS), and juvenile polyposis syndrome (JPS), which also provide guidance on polypectomy practices.^8–10“
• “No studies have directly compared the safety and efficacy of various polypectomy techniques—such as cold forceps, hot forceps, cold snare, and hot snare methods—in children. As a result, pediatric practices often rely on extrapolated adult data, despite key differences in patient populations.”

My take (borrowed from authors): “Polypectomy is central to pediatric endoscopy, yet evidence-based, pediatric-specific guidelines are lacking.”

Related article: Hoskins BJ, Grabau JM, Rex DK. J Pediatr Gastroenterol Nutr. 2025;81:1311-131. Pediatric endoscopic mucosal resection: a 10-year single-center experience. . https://doi.org/10.1002/jpn3.70194

Related blog posts:

• Cold vs Hot Polypectomy for Small Polyps (2023)
• How to Do a Colonoscopic Polypectomy & U.S. COVID-19 Tracker
• How Benign Are Juvenile Polyps?
• Adverse Events Following Pediatric Endoscopy -Previously Underestimated
• ESPGHAN Juvenile Polyposis Position Paper While the polyps described are not tubular adenomatous polyps, it is noted that guidelines in adults recommend followup in 5-10 years for a single (non-serrated) adenomatous polyp (Polyps: Clinical Decision Tool).
• Updated Guidelines on Genetic Testing/management for Hereditary GI Cancer Syndromes
• Surprising Genetic Mutations in Polyposis Study
• Polyposis in Pediatric Patients -Review
• Consensus guidelines after polypectomy | gutsandgrowth)
• Adenoma Detection Rate: Life or Death Quality Measure

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