This study aims to evaluate the efficacy and safety of Speedboat Submucosal Dissection (SSD) for large colorectal pedunculated polyps compared with conventional Hot Snare Polypectomy (HSP)

This retrospective, multicenter study was conducted at three tertiary hospitals in Thailand. The study period spanned from October 2022 to October 2025. We included patients diagnosed with large colorectal pedunculated polyps (Size≥2cm) who underwent endoscopic resection using either Speedboat Submucosal Dissection (SSD) or Hot Snare Polypectomy (HSP). Clinical data, including patient demographics, procedural details, and adverse events, were retrospectively collected from medical records. Statistical analysis was performed to compare the efficacy and safety outcomes between the two groups.

A total of 55 patients were included in the study, comprising 25 patients in the Speedboat Submucosal Dissection (SSD) group and 30 patients in the Hot Snare Polypectomy (HSP) group. The mean polyp size was 2.72 cm in the SSD group and 2.46 cm in the HSP group.

In terms of efficacy, the complete resection rate was 100% (25/25) in the SSD group compared with 93.3% (28/30) in the HSP group; however, this difference was not statistically significant (p = 0.495). Histopathological analysis revealed adenocarcinoma in 12% (3/25) of the SSD group and 13.3% (4/30) of the HSP group. Notably, the mean procedure time was significantly longer in the SSD group compared with the HSP group (94.28 min vs. 53.70 min, p = 0.020).

Regarding safety outcomes, there were no significant differences in adverse events between the two groups. Delayed bleeding was not observed in the SSD group (0%) but occurred in one patient (3.3%) in the HSP group (p = 1.000). No perforation occurred in either group.

Table 1. Compare Outcome

Our study demonstrates that Speedboat Submucosal Dissection (SSD) is a safe and feasible technique for the management of large pedunculated colorectal polyps when compared with conventional Hot Snare Polypectomy (HSP). A key finding of this study was the 100% complete resection rate achieved in the SSD group. Although this did not reach statistical significance compared to the HSP group, likely due to the limited sample size, the absolute success rate suggests that SSD offers high efficacy without compromising safety.

In terms of safety, SSD showed a comparable profile to HSP with no occurrences of serious complications, such as perforation or uncontrolled bleeding. However, it is important to note that the procedure time for SSD was significantly longer than that for HSP. This difference reflects the technical complexity of the SSD procedure, which involves precise submucosal dissection, compared to the more rapid snare technique.