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  • Thermal ablation of the resection base after endoscopic mucosal resection: a useful tool when perfect technique is not achievable

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Letter
Thermal ablation of the resection base after endoscopic mucosal resection: a useful tool when perfect technique is not achievable
  1. Roupen Djinbachian1,
  2. Daniel von Renteln2
  1. 1 Centre de recherche du CHUM, Montreal, Quebec, Canada
  2. 2 Medicine, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada
  1. Correspondence to Dr Daniel von Renteln, Medicine, Centre Hospitalier de L'Universite de Montreal, Montreal, QC H2W 1T8, Canada; danielrenteln{at}gmail.com

https://doi.org/10.1136/gutjnl-2023-331676

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    We welcome the excellent discussion from Mandarino et al regarding whether thermal ablation of resection base is warranted after endoscopic mucosal resection (EMR) of large non-pedunculated colorectal polyps.1 2 We agree with many of the points raised by the authors.

    Indeed, a perfect resection technique as evidenced by Mandarino et al is likely to reduce the need for base ablation; however, such perfect technique is not always possible be it due to polyp-related or endoscopist-related factors. Furthermore, perfect overlapping resections with wide margins would also theoretically preclude the need for snare tip soft coagulation (STSC) of the margins. However, if the theory of microscopic polyp remnants at the margins despite overlapping and wide resection holds true, then the same should be considered possible for the base. Several Randomised controlled trials (RCTs) comparing hot versus cold snare EMR have recently been presented.3 4 Cold snare consistently …

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    Footnotes

    • Contributors RD performed the literature search and DvR performed the expert review. Both authors drafted and revised the manuscript and critically reviewed the manuscript for important intellectual content.

    • Funding DvR is supported by a 'Fonds de Recherche du Québec Santé' career development award. RD is supported by a 'Fonds de Recherche du Québec Santé/Ministère de la Santé et des Services Sociaux' clinical research award.

    • Competing interests DvR has received research funding from ERBE Elektromedizin GmbH, Ventage, Pendopharm, Fujifilm, Satisfai Health and Pentax and has received consultant or speaker fees from Boston Scientific, ERBE Elektromedizin GmbH and Pendopharm.

    • Provenance and peer review Not commissioned; internally peer reviewed.