Cryotherapy for treatment of large nonlifting polyp at rectal anastomosis

A 61-year-old man with a history of stage II T3N0M0 rectal cancer was treated by low anterior resection. A year later, on surveillance colonoscopy, he was found to have a large 3-cm, Paris 0-IIa+IIb, nongranular, laterally spreading polyp at the anastomosis site (A). The results of examination of a biopsy specimen were indicative of a tubulovillous adenoma. EMR could not be performed because the polyp could not be lifted by submucosal injection as a result of fibrosis and scarring.