Precutting endoscopic mucosal resection (EMR-P) is an established modification of conventional EMR for removing large nonpedunculated colorectal polyps, enabling controlled mucosal incision before snare resection. However, uncertainty persists regarding whether a snare-tip provides comparable efficacy and safety to an endoscopic submucosal dissection (ESD) knife during precutting. This randomized controlled trial aimed to evaluate whether snare-tip EMR-P is noninferior to ESD knife–assisted EMR-P for polyps measuring 15–25 mm.
A total of 106 patients were randomized equally between the two techniques. En bloc resection rates were identical at 98.1% in both groups, with no significant difference in R0 resection rates (88.7% vs 92.5%). Procedure times were comparable (8.9 min vs 9.3 min), local recurrence was 0% in both arms, and no perforations were reported, supporting similar safety…
