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News

Incomplete polyp resection during colonoscopy

This month's issue of Gastroenteorology reports on the results of the Complete Adenoma Resection (CARE) Study.

News image

Dr Heiko Pohl and colleagues from Canada performed a prospective study on 1427 patients who underwent colonoscopy at 2 medical centers, and had at least 1 nonpedunculated polyp.

After polyp removal was considered complete macroscopically, biopsies were obtained from the resection margin. 

The team of doctors' main outcome was the percentage of incompletely resected neoplastic polyps determined by the presence of neoplastic tissue in post-polypectomy biopsies. 

Associations between incomplete resection rate and polyp size, morphology, histology, and endoscopist were assessed by regression analysis.
 
The research team found that of 346 neoplastic polyps removed by 11 gastroenterologists, 10% were incompletely resected. 
10% were incompletely resected
Gastroenterology

The team noted that the incomplete resection rate  increased with polyp size, and was significantly higher for large than small neoplastic polyps, and for sessile serrated adenomas/polyps than for conventional adenomas. 
 
The team of doctors noted that the incomplete resection rate for endoscopists with at least 20 polypectomies ranged from 7% to 23%.
 
The researchers found about a 3-fold difference between the highest and lowest incomplete resection rate after adjusting for size and sessile serrated histology.
 
Dr Pohl's team concludes, "Neoplastic polyps are often incompletely resected, and the rate of incomplete resection varies broadly among endoscopists."
 
"Incomplete resection might contribute to the development of colon cancers after colonoscopy."
 
"Efforts are needed to ensure complete resection, especially of larger lesions."

Gastroenterology 2013:144(1): 74-80
14 January 2013

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