Sir,We read with great interest the article recently published by Oh et al.[1] comparing the efficacy and safety of cold snare polypectomy (CSP) and endoscopic mucosal resection (EMR) in patients with end-stage renal disease (ESRD). The authors concluded that there were no differences between the CSP and EMR groups in terms of efficacy and safety, and we completely agree with the recommendation of CSP for the removal of 3–10 mm-sized colorectal polyps in patients with ESRD. However, we would like to emphasize a few points of concern.First, the authors did not specify whether the included patients had single or multiple polyps, as multiple colorectal polyps are more common in clinical practice. First, a bleeding case should refer to a specific patient rather than an individual polyp, unless the patients with multiple polyps were excluded. Indeed, the number of polyps should also be considered as another variable of risk factors for immediate bleeding when considering the presence of multiple polyps.Second, we doubt that it might be difficult to accurately assess the lateral or basal positive margin of incomplete resection for small and diminutive colorectal polyps. To our knowledge, the specimens of benign lesions smaller than 10 mm are not routinely immobilized and labeled on flat surfaces before pathological evaluation. As a result, we consider it questionable to identify these incomplete resection cases.Third, the authors concluded that the size of the polyp was significantly associated with immediate bleeding and incomplete resection. To further explore the thresholds of polyp size to develop immediate bleeding and incomplete resection, respectively, receiver operating characteristic curve analysis could be performed to determine the cut-off value for prediction.