Incomplete resection rate higher for larger polyps and sessile serrated adenomas/polyps
FRIDAY, Jan. 18 (HealthDay News) -- About 10 percent of neoplastic polyps are incompletely resected, with considerable variation in the rate of incomplete resection between endoscopists, according to a study published in the January issue of Gastroenterology.
Heiko Pohl, M.D., from the VA Medical Center in White River Junction, Vermont, and colleagues obtained biopsies from resection margins of patients with at least one non-pedunculated polyp (5 to 20 mm) detected and removed during colonoscopy. The incomplete resection rate (IRR) was determined by the presence of neoplastic tissue in post-polypectomy biopsies.
The researchers found that 10.1 percent of the 346 neoplastic polyps (269 patients; 84.0 percent men; mean age, 63.4 years) removed by 11 gastroenterologists were incompletely resected. The IRR was significantly higher for large (10 to 20 mm) versus small (5 to 9 mm) neoplastic polyps (17.3 versus 6.8 percent; relative risk, 2.1), and also for sessile serrated adenomas/polyps versus conventional adenomas (31.0 versus 7.2 percent; relative risk, 3.7). The IRR ranged from 6.5 to 22.7 percent for endoscopists with at least 20 polypectomies. After adjustment for size and sessile serrated histology, there was a 3.4-fold difference between the highest and lowest IRR for endoscopists.
"Our results suggest a need for quality metrics evaluating polyp resection," the authors write. "The performance of high-quality and effective colonoscopy not only requires expertise in finding neoplastic polyps, but also removing them."