We congratulate Djinbachian et al on their recent publication that addressed the utility of hybrid argon plasma coagulation (hAPC) to mitigate recurrence after endoscopic mucosal resection (EMR) of large non-pedunculated colorectal polyps (LNPCPs).1 In a 3-centre study, involving 391 patients (427 LNPCPs), they reported a lower residual or recurrent adenoma rate (RRA of 0.9%) with combined margin and base ablation, when compared with margin ablation alone (8.8%) or no ablation (23.4%).

The insights presented in this paper open discussion on the potential enhancement of EMR outcomes. Our extensive 15-year research experience at Westmead Hospital, Sydney, aligns closely with this topic.

The authors’ rationale behind base ablation is the need to treat polyp areas that might evade capture during a piecemeal resection. However, a systematic approach to LNPCP EMR may preclude its occurrence. This involves a systematic resection, starting from the lesion’s edge, ensuring a wide margin and proceeding in a one-way direction. Once the submucosal plane is entered, it is important that subsequent snare placement …