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We thank Jacques and colleagues for their critical appraisal of our manuscript.1 2 Although recurrence is a shortcoming of wide-field endoscopic mucosal resection (WF-EMR), it is typically unifocal, diminutive and its management does not add substantial cost beyond that of the surveillance colonoscopy. Our base case rate of 14.4% was determined from our large prospective WF-EMR cohort and is consistent with a recent meta-analysis (13.8%).3 We modelled recurrence rates following endoscopic submucosal dissection (ESD) that were six- to sevenfold lower and in line with the rates quoted by the French group. Our modelled assumptions reflect contemporary evidence and favour ESD given adjunctive thermal ablation of the post-EMR margin4 has been shown to reduce recurrence following WF-EMR to 5%–6% including for larger lesions.
ESD is a …
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