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A novel method for determining the difficulty of colonoscopic polypectomy.

S Gupta¹, D Miskovic², P Bhandari³

¹Wolfson Unit for Endoscopy, St Mark's Hospital and Imperial College London, Harrow, UK.

Frontline Gastroenterology

|August 26, 2017

Summary

This summary is machine-generated.

A new scoring system reliably measures colon polyp removal difficulty using size, morphology, site, and access. This system categorizes polyps into four levels, aiding training and service delivery.

Keywords:

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Area of Science:

Gastroenterology
Endoscopic Surgery

Background:

Colonic polypectomy is a routine endoscopic procedure.
Polypectomy difficulty varies based on polyp characteristics like size, morphology, location, and access.
A standardized method to measure polypectomy difficulty has been lacking.

Purpose of the Study:

To develop and validate a scoring system for assessing the difficulty of colonic polypectomy.
To define distinct complexity levels for colon polyps.

Main Methods:

A Delphi method involving nine endoscopists identified key polyp parameters influencing difficulty.
A scoring system was developed based on size, morphology, site, and access.
The scoring system was validated by two expert endoscopists.

Main Results:

Four factors (size, morphology, site, access) were identified as crucial for determining polypectomy complexity.
A scoring system assigning points to each factor was established.
Four polyp complexity levels (I-IV) were defined based on total scores, demonstrating high interrater reliability (ICC=0.93, κ=0.888).

Conclusions:

The developed scoring system is feasible and reliable for assessing colon polyp complexity.
Defining polyp complexity levels can enhance training, competency assessment, and certification in colonoscopic polypectomy.
This system may improve the efficiency of endoscopic service delivery and referral pathways.