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Endoscopic mucosal resection (EMR) of large sessile polyps in the colon carries substantial risk for perforation. To test a marker that would promptly identify muscularis propria resection and perforation, researchers prospectively studied 445 patients who underwent EMR of large sessile polyps or laterally spreading tumors (≥20 mm) at a single gastroenterology center in Australia during a 40-month period.
During EMR, colonoscopists examined the undersides of resected specimens for a target sign: a central white or cauterized elevated portion representing partial or full-thickness muscularis propria resection. Affected patients often have a corresponding depressed area or divot visible in the base of the polypectomy defect. All instances of m…