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. 2020 Oct-Dec;61(4):1301-1307.
doi: 10.47162/RJME.61.4.31.

The quality of colorectal polypectomy. Is it enough to have just a visual assessment of the site?

Mihaela Caliţa  1 , Dan Nicolae Florescu, Costin Teodor Streba, Andreea Doriana Stănculescu, Mirela Marinela Florescu, Petrică Popa, Dan Ionuţ Gheonea, Carmen Nicoleta Oancea, Adrian Săftoiu
Affiliations

The quality of colorectal polypectomy. Is it enough to have just a visual assessment of the site?

Mihaela Caliţa et al. Rom J Morphol Embryol. 2020 Oct-Dec.

Abstract

Introduction: Performing a colonoscopy allows the examination of the entire colon and the assessment of polyps.

Patients, materials and methods: We performed a retrospective analysis of prospectively collected data from January 2018 until February 2020 (two years), in which we enrolled a number of 210 patients performing colonoscopy in the Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Romania. We performed 326 polypectomies.

Results: We classified the polyps into diminutive (n=169), small (n=103) and large polyps (n=54). Regarding the polypectomy technique, our results indicated that 40 out of 48 (83.3%) polypectomies with the biopsy forceps were complete, as well as 27 out of 31 (87.1%) cold snare polypectomies and 12 out of 14 (85.7%) hot snare polypectomies. The differences were not statistically significant (p=0.116). Regarding the number of incomplete polypectomies, our data suggests that the high expertise endoscopist had two incomplete resections (5.1% of total), the medium expertise endoscopist 1 had also two incomplete resections (11.1% of total), the medium expertise endoscopist 2 had three incomplete resections (15% of total), the limited expertise endoscopist 1 had three incomplete resections (27.27% of total) and the limited expertise endoscopist 2 had four incomplete resections (30.76% of total). Analyzing the data, the differences were statistically significant (p=0.006).

Conclusions: Our study is able to suggest that high-definition white-light endoscopy (HD-WLE) macroscopic visualization of the polyp resection site is not enough to assess complete polyp resection and follow-up colonoscopy should be performed for cases with incomplete margins of resection.

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Conflict of interest statement

The authors declare that they have no conflict of interests.

Figures

Figure 1
Figure 1
Enhancement of cases based on histopathological report.
Figure 2
Figure 2
(A) Large pedunculated polyp in HD–WLE; (B) Resection site; (C) Tubular adenoma with high-grade dysplasia (HE staining, 50×). HD–WLE: High-definition white-light endoscopy; HE: Hematoxylin–Eosin
Figure 3
Figure 3
– (A) Small sessile polyp in HD–WLE; (B) Resection site after hot snare polypectomy; (C) Microvesicular hyperplastic polyp (HE staining, 50×). HD–WLE: High-definition white-light endoscopy; HE: Hematoxylin–Eosin
Figure 4
Figure 4
(A) Large sessile polyp in HD–WLE; (B) Resection site; (C) Tubulovillous adenoma with high-grade dysplasia (HE staining, 50×). HD–WLE: High-definition white-light endoscopy; HE: Hematoxylin–Eosin
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