Adverse events and residual lesion rate after cold endoscopic mucosal resection of serrated lesions ≥10 mm

Background and Aims: Cold EMR is being increasingly used for large serrated lesions. We sought to measure residual lesion rates and adverse events after cold EMR of large serrated lesions. Methods: In a single academic center, we retrospectively examined a database of serrated class lesions >= 10 mm removed with cold EMR for safety and efficacy. Results: Five hundred sixty-six serrated lesions >= 10 mm in size were removed from 312 patients. We successfully contacted 223 patients (71.5%) with no reported serious adverse events that required hospitalization, repeat endoscopy, or transfusion. The residual lesion rate per lesion at first follow-up colonoscopy was 18 of 225 (8%; 95% confidence interval, 5-12.1). Lesions with residual were larger at polypectomy compared with lesions without recurrence (median, 23 mm versus 16 mm, P = .017). Conclusion: Cold EMR appears to be safe and effective for the removal of large serrated lesions.