← Issue №8/ week of Aug 23, 2026/Endoscopy

Hemostatic Efficacy and Safety of the Hybrid Injector ClearCoajet in Endoscopic Mucosal Resection of Large Colorectal Polyps: A Multicenter Randomized Trial.

From GI Signals issue №8: what this paper found, what it changes, and where it sits against the current standard of care, reviewed by Simon Mathews, MD.

Endoscopy rct · Aug 18, 2026 · Dig Dis Sci · IF 2.5

Hemostatic Efficacy and Safety of the Hybrid Injector ClearCoajet in Endoscopic Mucosal Resection of Large Colorectal Polyps: A Multicenter Randomized Trial.

New therapyEMRhemostasisadenoma
Clinical takeawayFor hemostasis of intraprocedural bleeding during large polyp EMR, snare-tip hemostasis remains the standard approach; ClearCoajet offers a potential alternative if available, but this underpowered trial does not demonstrate clear superiority. No change in current hemostasis practice is required based on this evidence.
What it foundHemostasis success during EMR was 96.4% with ClearCoajet available (27/28 cases) versus 84.0% with snare-tip only (21/25 cases), a 12.4 percentage point difference (95% CI -4.7 to 31.3, P = 0.176); the difference was not statistically significant.
ContextIntraprocedural bleeding complicates 24% of large polyp EMR procedures and is typically managed with snare-tip hemostasis. This trial evaluates a hybrid device combining heat probe and injector as an adjunct; the nonsignificant trend toward improved success does not establish clear advantage over established technique.
Emergingsuggested applicable standard· US Multi-Society Task Force on Colorectal Cancer (Gupta S, et al.), "Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2020

Decision at stakeSelection of hemostatic technique for managing intraprocedural bleeding during endoscopic mucosal resection

Confirm complete resection and adequate prep before applying an interval, and use site-check/tumor-board pathways for piecemeal resection and malignant (T1) polyps.

From our summary of this standard, unedited — the part the paper bears on. marks omitted text. Our wording, not the guideline's; read the source for its own text.

Our full summary of this standard

After polyp removal, assign the next colonoscopy surveillance interval using USMSTF 2020 based on polyp number, size, and histology (e.g., 1-2 tubular adenomas <10 mm 7-10 years; 3-4 tubular adenomas <10 mm 3-5 years; 5-10 tubular adenomas <10 mm, any adenoma ≥10 mm, or adenoma with tubulovillous/villous histology or high-grade dysplasia 3 years; >10 adenomas 1 year with polyposis evaluation; and for serrated polyps, 1-2 sessile serrated lesions <10 mm 5-10 years, 3-4 sessile serrated lesions <10 mm or a hyperplastic polyp ≥10 mm 3-5 years, and a sessile serrated lesion ≥10 mm or with dysplasia or a traditional serrated adenoma 3 years), and apply the shortest interval indicated when findings are mixed. Confirm complete resection and adequate prep before applying an interval, and use site-check/tumor-board pathways for piecemeal resection and malignant (T1) polyps. Refer for genetic evaluation when Lynch, FAP/AFAP/MAP, or serrated polyposis syndrome criteria are met.

US Multi-Society Task Force on Colorectal Cancer (Gupta S, et al.), "Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2020 · reviewed 2026-07-23 ↗
Nam Y … Lee HS · Digestive Diseases and Sciences · IF 2.5 · PubMed ↗Permalink
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