Avulsion for the treatment of visible residual neoplasia during EMR of colorectal polyps: Is “heat” required?

We read with great interest the article by Holmes et al1 on the superiority of avulsion to argon plasma coagulation (APC) in treating residual neoplasia. However, we question whether the additional diathermy and shearing effect using "hot" avulsion (HA) with the use of EndoCut is required. The cold avulsion (CA) technique has been used in our institution for several years for residual polyps, by use of the hot biopsy forceps because of the favorable cusps (Radial Jaw 4, Boston Scientific, Natick, Mass).

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