Endoscopic Mucosal Resection Is Effective for Large Serrated Polyps

In the CARE study, sessile serrated polyps (SSPs) were five times more likely to be incompletely resected than were 5- to 20-mm conventional adenomas, and half of the 10- to 20-mm serrated lesions were ineffectively resected. Two subsequent studies showed that endoscopic mucosal resection (EMR) using a contrast agent in the submucosa was effective for lesions ≥20 mm and those ≥10 mm.

In a prospective study, researchers in Australia assessed EMR of 323 SSPs (in 246 patients) and 1527 conventional adenomas (in 1425 patients). Technical success for EMR was significantly better for SSPs than conventional adenomas (99.1% vs. 94.5%). Among lesions of 20 mm to 25 mm, recurrence was eight times more likely for conventional adenomas than for SSPs; am…