Randomized Trial of Cold EMR Compared to Hybrid Cold EMR.
Trial Parameters
Brief Summary
The goal of this randomized clinical trial is to learn if a combination of hot and cold EMR technique is associated with a lower risk of polyp recurrence without increasing the risk of complication when removing large polyps. Participants will undergo EMR and return for a follow-up endoscopy in 3-6 months to check for polyp recurrence.
Eligibility Criteria
Inclusion Criteria: * Adult patient (age 18 years or older) * Polyp size of at least 20 mm * \- Morphology: Flat or superficially raised polyp morphology (i.e., Paris classification 1s, 0-IIa or 0-IIb, or a combination of the above) Exclusion Criteria: * Polyps with previous failed resection attempts or polyp recurrence * Suspected deep submucosal invasion on endoscopic assessment of surface mucosal pit pattern (Kudo V or NICE 3 pattern) or histologically confirmed malignancy (invasive adenocarcinoma) * Polyps with nodules too large (\>1-1.5cm) for the use of a cold snare * Inflammatory bowel disease