By CAFMI AI From Gut
Effectiveness of Thermal Ablation in Reducing Polyp Recurrence
Endoscopic mucosal resection (EMR) is a common procedure for removing large non-pedunculated colonic polyps measuring 20 mm or more. While EMR effectively removes these potentially pre-cancerous polyps, recurrence rates remain a challenging issue, often due to neoplastic tissue left at the resection margins. This study analyzed the effect of adding thermal ablation to the margins immediately following EMR to target residual cells that might cause regrowth. The research compared long-term outcomes for patients treated with EMR alone versus those who received thermal ablation of the resection margins after EMR. Results demonstrated a significant reduction in the rate of polyp recurrence among patients who had margin thermal ablation. This finding suggests that thermal ablation can successfully destroy leftover tissue that might otherwise lead to adenoma recurrence, reinforcing its value as a procedural adjunct.
Clinical Safety and Practical Implications for Primary Care
Beyond confirming efficacy, the study also addressed safety concerns, reporting no significant increase in adverse events with the addition of thermal ablation. This is important for clinical practice as it supports margin thermal ablation as a safe intervention that does not add substantial risk to the EMR procedure. For primary care clinicians, understanding this advancement aids counseling patients referred for polyp resection about potential procedural options and outcomes. It also highlights the relevance of close collaboration with gastroenterologists to ensure optimal follow-up care and surveillance, especially for patients with large polyps at increased risk of recurrence.
Recommendations for Integrating Thermal Ablation in Routine Care
Given the compelling evidence of reduced recurrence rates and a strong safety profile, margin thermal ablation should be considered as a routine addition to EMR for large non-pedunculated colonic polyps. Reducing recurrence has clear benefits, potentially lowering the need for repeat endoscopic procedures, thus improving patient quality of life and decreasing healthcare costs. Primary care physicians should be aware of this option when managing patients with large colonic polyps and discussing long-term surveillance strategies. By integrating this knowledge into practice, clinicians can better support preventive strategies against colorectal cancer development.
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