Indiana University
The study will compare the use of cold snare piecemeal resection (CSPR) vs cold endoscopic mucosal resection (Cold EMR). The study will include two cohorts: one cohort for conventional adenomas 10-19mm in size and one cohort for serrated lesions 10mm or larger.
Inclusion Criteria: 1. ≥ 18 years of age 2. Presenting for a screening, surveillance, diagnostic, or therapeutic colonoscopy 3. Found to have: * a sessile serrated lesion or hyperplastic polyp ≥ 10 mm during procedure (Serrated Cohort) or * a 10-19 mm conventional adenoma during procedure (Adenoma Cohort) 4. Ability to provide informed consent Exclusion Criteria: 1. Pedunculated or semi-pedunculated polyps (as defined by Paris Classification type Ip or Isp) 2. Polyps confirmed to be anything other than: * sessile serrated lesion or hyperplastic polyp on histologic diagnosis (Serr…
Qualifying polyps randomized to Cold Snare Piecemeal Resection (CSPR) will be removed using cold snare techniques (no electrocautery, no submucosal injection.)
Qualifying polyps randomized to Cold Snare Endoscopic Mucosal Resection (Cold EMR) will be removed using cold snare techniques (no electrocautery, with submucosal injection.)
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