Grant: Project Grant

Colorectal cancer (CRC) is a leading cause of cancer-related deaths, but can often be prevented by removing precancerous polyps. Large colorectal polyps (>20mm) have the highest risk of developing into CRC and require complete removal to prevent cancer. Non-Thermal Endoscopic Mucosal Resection (NT-EMR) is a new minimally invasive procedure used to remove these polyps, but about 30% of patients experience polyp recurrence, leading to additional procedures, higher healthcare costs, and a potential risk of CRC. Recurrence occurs when microscopic remnants of the polyp remain after NT-EMR. To reduce this risk, microscopic remaining tissue can be destroyed with heat using a technique called Hybrid Argon Plasma Coagulation (h-APC). However, this technique has never been tested in comparison to NT-EMR without ablation. We will perform a randomized controlled trial where patients with large colorectal polyps will be randomly assigned to receive NT-EMR with and without ablation. Our goal is to determine whether performing ablation after NT-EMR can reduce the chance of recurrence of large colorectal polyps.