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Cold snaring is effective and safe for removing colorectal polyps smaller than 10 mm. Now, two Australian endoscopists report an observational study of piecemeal cold snare resection of sessile serrated polyps ≥10 mm in size, performed in combination with submucosal injection (cold endoscopic mucosal resection [EMR]). In all, 163 lesions were removed (105 procedures in 99 patients). Procedures used a dedicated cold snare or a stiff 10- or 15-mm snare.
Mean and median SSP sizes were 17.5 mm and 15.0 mm, respectively; 61 lesions were ≥20 mm and 13 were ≥30 mm in size. Nearly all were in the proximal colon. In 1.2% of lesions, one of four quadrant biopsies from the rim of the completed resection site was positive. Surveillance colonoscopy was p…