Safety of endoscopic resection of large colorectal polyps: A randomized trial.
The purpose of the study is to learn what method has the lowest risk of complications when removing a large polyp. Polyps are abnormal growths of tissue and are removed to reduce the risk for developing cancer. This is especially important for large polyps, which have a higher cancer risk. Unfortunately, removal of large polyps is associated with a higher risk of complications than removal of the “average” small polyp (most polyps are less than 0.5 cm). It is not clear which of several commonly used methods have the lowest risk. With this study we examine whether the risk of bleeding (typically anywhere between 3 and 10%) can be reduced, if we close the defect in the uppermost lining (called mucosa) after removing the polyp. We typically use clips for closing the mucosa. Clipping is a common and safe method and is also used for other endoscopic procedures. Gastroenterology endoscopists sometimes use these clips and sometimes they don’t. We are doing this study to understand which approach is better. We will also examine the risk with using two different electrocautery settings for polyp resection. Again, these two setting are commonly used to resect polyps, and we do not know whether one is better than the other with respect to complications.