Efficacy, Safety and Recurrence After Cold-EMR Plus APC for Large Colonic Lesions

Prospective Observational Study APC AND BIOPSY POST COLD-EMR IN COLONIC LESIONS

This prospective observational study aims to evaluate the efficacy, safety and recurrence of cold-snaring for large colonic lesions combined with argon plasma coagulation of the resection bed.

Inclusion Criteria:

• All patients aged ≧ 18 years undergoing colonoscopy for any indication (screening, anemia, surveillance, or scheduled to undergo endoscopic mucosal resection)
• Lesions of 20 mm and larger.
• All colonic lesions removed using COLD-EMR technique, presenting both adenomatous (Kudo IIIL/IIIS pit pattern)
• Patients who were able to provide written informed consent

Exclusion Criteria:

• Suspected lesions for submucosal invasion (e.g., Kudo V or Paris 0-IIa-IIc with non-granular surface)
• Lesions with a wide Paris 0-Is component (>10mm) that could increase the risk of submucosal invasion and could limit the mechanical cutting of the snare
• Pedunculated polyps
• Active/quiescent colitis
• Rectal lesions
• Residual or recurrent adenoma after endoscopic mucosal resection