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Objectives: Data of long-term follow up for large non pedunculated colorectal polyps (LNPCPs) ≥4 cm removed with piecemeal wide field endoscopic mucosal resection (PWF-EMR) are limited. We primarily evaluated the recurrence rates and secondarily the rates of post colonoscopic polypectomy colorectal cancer (PCPCRC) on a long-term basis., Methods: We retrospectively reviewed a prospectively-stored electronic database of all patients who underwent PWF-EMR for LNPCPs at the Venizeleion General Hospital, between 2009 and 2020. Eligible patients were those with LNPCPs ≥4 cm, deemed completely removed by endoscopic means and followed-up for a minimum of 36 months with at least two surveillance colonoscopies, the first one (SC1) (4-6) months after the initial PWF-EMR procedure and the second one (SC2) after (12-18) months. In 2023, all cases were checked for PCPCRC development., Results: Residual/early recurrent tissue was detected in 44 (31 %) cases among the 142 (82 males, 60 females) assessed during SC1. Late recurrent tissue was detected in 9 (6.6 %) cases among the 137 surveyed during SC2. Investigation did not reveal any case of PCPCRC ., Conclusions: This historical cohort shows that the PWF-EMR for LNPCPs ≥4 cm is a safe and definitive removal method while it is not associated with the appearance of PCPCRC., Competing Interests: Conflict of interest No Conflict of Interest., (Copyright © 2024. Published by Elsevier Ltd.)

This article, published in the journal Endoscopy, presents the findings of a study conducted in Greece on the recurrence of adenomas and the development of colorectal cancer following piecemeal endoscopic mucosal resection (EMR) in large non-pedunculated colonic polyps (LNPCPs) that are 4cm or larger. The study included 142 patients with a median age of 67 years, and the median polyp size was 5cm. The results showed that early recurrence or residual tissue was found in 30.3% of the polyps, while late recurrence occurred in 8.5% of the cases. No patients developed colorectal cancer during the follow-up period. The study concludes that EMR is an effective method with low recurrence rates and no incidence of colorectal cancer for LNPCPs≥4cm. [Extracted from the article]