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Endoscopic mucosal resection (EMR) is a safe and effective definitive therapy for large noninvasive, laterally spreading colorectal lesions. However, a limitation of EMR is residual and recurrent neoplasia, which has been reported in up to 30% of cases.
To determine if adjuvant thermal ablation of EMR defect margins can reduce polyp recurrence, investigators in Australia conducted a multicenter randomized trial, in which resections of 416 laterally spreading lesions ≥20 mm were performed for 390 patients. After all visible neoplasia had been resected, the lesions were randomized to thermal ablation of the EMR resection margin or no additional therapy. Thermal ablation was applied to the entire margin using a 1–2 mm exposed snare tip in SOFT …