Endoscopic Mucosal Resection of Large Sessile Colorectal Polyps

Surgery is commonly used to remove large sessile colorectal polyps but carries substantial risk for morbidity and mortality. Endoscopic mucosal resection (EMR) is a lower-risk alternative, but robust efficacy studies have been lacking. Now, in a prospective study involving patients identified through previous colonoscopy, Australian researchers at seven academic endoscopy centers evaluated the safety and efficacy of EMR for colorectal polyps ≥20 mm.

Of 479 patients (mean age, 69) with 514 lesions (mean size, 35.6 mm), EMR was attempted in 97% of patients, and complete excision was achieved in 89%. Multivariate analyses showed that a previous attempt at EMR, involvement of the ileocecal valve, or difficult position of the lesion for EMR predi…