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Experts in endoscopic mucosal resection (EMR) generally agree that snaring of colorectal, lateral-spreading tumors should be used whenever possible, and ablative techniques should be reserved for lesion portions that are too flat and resistant to snaring. Accepted ablation techniques include argon-plasma coagulation and snare-tip cautery in the soft coagulation mode. Although avulsion techniques for treatment of unsnareable, flat polyps have recently been described, follow-up is limited on the efficacy of eradication.
In the current study, hot avulsion was used to remove nonlifting, flat areas of colonic polyps in 20 patients. Two experienced endoscopists performed the technique, as follows: Hot biopsy forceps were used to grasp the flat tis…