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 …

中文翻译：

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内镜下粘膜切除术后切除基底的热消融：在无法实现完美技术时的有用工具


我们欢迎 Mandarino 等人就大型无蒂结直肠息肉的内镜粘膜切除 (EMR) 后是否需要切除基底部热消融进行的精彩讨论。1 2 我们同意作者提出的许多观点。事实上，Mandarino 等人证明的完美切除技术可能会减少基底部消融的需要；然而，由于息肉相关或内窥镜医生相关的因素，这种完美的技术并不总是可能的。此外，从理论上讲，具有宽边缘的完美重叠切除也可以排除对边缘进行圈套器尖端软凝固（STSC）的需要。然而，如果尽管重叠和广泛切除，边缘仍存在微观息肉残留的理论成立，那么对于基底部来说，同样的情况也应该被认为是可能的。最近提出了几项比较热圈套 EMR 与冷圈套 EMR 的随机对照试验 (RCT)。3 4 冷圈套始终如一……