LAUSR

foration and cannot lead to the post-polypectomy syndrome that is associated with traditional, or hot snare, polypectomy (HSP) involving electrocautery. Extensive research has documented that the risk of bleeding after CSP for subcentimeter polyps is similar or smaller than that after HSP [1]. Meta-analyses have shown that the incomplete resection rate (IRR) is comparable between the two methods, but varies markedly between the studies (0–25%), with significant heterogeneity [1, 2]. The quality of evidence has been rated as very low. Some of the variation is probably caused by differences in study settings, with the lowest IRRs coming from academic expert centers. Complete resection of colorectal polyps is of obvious importance. It has been estimated that 20% of post-colonoscopy cancers may be caused by incompletely removed polyps [3]. In this issue of Endoscopy, von Renteln et al. offer another piece of the puzzle regarding the usefulness of the CSP technique [4]. In their single-center prospective cross-sectional study, the authors investigated the IRR of 128 colorectal polyps sized 4–20mm. The nine endoscopists who participated in the study were all board-certified and had extensive colonoscopy experience. After the removal of all visible polyp tissue, completeness of removal was assessed by biopsies obtained from the resection margins. The IRR was disappointingly high: 18% of polyps of 4–9mm and 21% of polyps of 10–20mm were not completely removed.