Resection of large sessile serrated polyps by cold piecemeal endoscopic mucosal resection: Serrated COld Piecemeal Endoscopic mucosal resection (SCOPE)

Abstract

Resection of large sessile serrated polyps by cold piecemeal endoscopic mucosal resection: Serrated COld Piecemeal Endoscopic mucosal resection (SCOPE) Sessile serrated adenomas/polyps (SSA/ Ps) are frequently found in the proximal colon, where the wall is thinner and easily damaged by diathermy during polypectomy, which also carries a risk of delayed bleeding, perforation, and post-polypec-tomy syndrome. SSA/Ps are often flat with subtle, irregular edges making endoscopic assessment of their extent difficult [1]. This can lead to incomplete resection and risk of post-colonoscopy cancer [2]. Currently, cold snare resection (CSR) is considered the preferred technique to resect small polyps. It is safe, time efficient, and user friendly [3]. Recently, case series have highlighted the safety and efficiency of CSR for larger adeno-E-Videos Fig. 1 Resection of a large sessile serrated polyp by cold piecemeal endoscopic mucosal resection (SCOPE) technique. a A 40-mm sessile serrated adenoma/polyp in the ascending colon; the edges are enhanced by chromoendoscopy. b Complete resection was achieved using the SCOPE technique. c No recurrence was observed at follow-up colonoscopy. d Normal mucosa in continuity with a serrated polyp highlights complete resection of the lesion (B1, normal mucosa; B2, serrated polyp).