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Factors associated with failed polyp retrieval at screening colonoscopy

A study in this month's issue of Gastrointestinal Endoscopy evalautes the cause of failed polyp retrieval at screening colonoscopy.

News image

Colonoscopy reduces colorectal cancer mortality and morbidity principally by the detection and removal of colon polyps.

It is important to retrieve resected polyps to be able to ascertain their histologic characteristics.

Dr Yoriaki Komeda and colleagues from the United Kingdom evaluated the cause of polyp retrieval failure.

Bowel cancer screening colonoscopy data were collected prospectively.

Screening participants were referred to a screening center after a positive fecal occult blood test result.

The polyp retrieval rate was 94%
Gastrointestinal Endoscopy

The team report that a total of 4383 polyps were endoscopically removed from 1495 patients from 2006 to 2011.

The research team's main outcome measures included the number, size, shape, and location of polyps, polyp removal method, quality of bowel preparation, total examination time, and insertion and withdrawal times.

The polyp retrieval rate was 94%, and the failure rate was 6%, thus 267 polyps were not retrieved.

In univariate analysis, factors affecting polyp retrieval failure were small polyp size, sessile polyps, and cold snare polypectomy.

The team found that polyp retrieval was less successful in the proximal colon.

In multivariate analysis, polyp size and method of removal were independent risk factors for polyp retrieval failure.

Dr Komeda's team commented, "Small polyp size and cold snare removal were found to be significantly associated with polyp retrieval failure."

"It was difficult to retrieve small, sessile, and proximal colon polyps."

"Optical diagnosis could be an efficacious option as a surrogate for histologic diagnosis for these lesions in the near future."

Gastrointest Endoscopy 2013: 77(3): 395-400
14 March 2013

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