Piecemeal Resection and Advanced Histology Independently Predict Local Recurrence After Colorectal Snare-based Endoscopic Resection: a Time-to-event Cohort Study

The objective of this retrospective cohort observational study is to identify variables related to the recurrence of colorectal lesions after snare polypectomy resection in colonoscopies. It also aims to evaluate the safety of the procedure. The main questions to be answered are: * What endoscopic characteristics are most related to recurrence? * What adverse events are related to the procedure? The researchers will perform a chart analysis looking for demographic, clinical, endoscopic, and histological variables in order to identify which factors are most closely linked to the recurrence of previously resected lesions.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Age ≥ 18 years at the time of polypectomy;
* Underwent snare polypectomy, with or without the use of thermal energy (cold snare or hot snare), performed during the study period (2023-2025);
* Procedure performed at a participating tertiary center, ensuring technical and record standardization;
* Availability of histopathological examination of the resected lesion, allowing for adequate histological characterization;
* Performance of at least one documented surveillance colonoscopy, with evaluation of the previous resection site;
* Adequate recording of clinical and endoscopic variables necessary for analysis (lesion size, location, resection technique, etc.);

Exclusion Criteria:

* Patients undergoing techniques other than loop polypectomy, such as: Endoscopic submucosal dissection (ESD), advanced mucosal resection not based on conventional loop, primary surgical resection of the lesion;
* Absence of follow-up colonoscopy, making it impossible to assess the primary outcome (local recurrence);
* Incomplete clinical, endoscopic, or histopathological data that prevent adequate classification of study variables;
* Invasive lesions beyond the mucosa (invasive cancer with deep submucosal invasion) that have been referred for immediate surgical treatment without endoscopic follow-up;
* Loss to follow-up before the first surveillance colonoscopy.

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