Connecting the dots to eliminate recurrence after endoscopic mucosal resection in the colon

Innovations in EMR over the past decade have solidified its position as the preferred first-line intervention for large (≥20 mm) non-pedunculated colorectal polyps (LNPCPs). Careful optical assessment and lesion selection, together with technologic advances, have allowed the safe and effective removal of LNPCPs without features of submucosal invasive cancer by EMR. The major historical limitations of EMR, including intraprocedural bleeding, clinically significant post-EMR bleeding, recognition and treatment of deep mural injury, and the removal of lesions in difficult locations (ileocecal valve and anorectal junction), have all been largely overcome by scientific study.