Incomplete endoscopic resection of colorectal polyps: a prospective quality assurance study

Area of Science:

• Gastroenterology
• Colorectal Cancer Screening
• Endoscopic Procedures

Background:

• Colorectal cancer (CRC) incidence is reduced by endoscopic screening and polypectomy.
• Incomplete polyp removal can lead to post-colonoscopy cancers, potentially diminishing screening effectiveness.

Purpose of the Study:

• To quantify the rate of incomplete polyp removal during routine colonoscopies.
• To identify factors associated with incomplete polyp resection.

Main Methods:

• Patients aged 50-75 with non-pedunculated polyps (≥5mm) underwent polypectomy at four Norwegian hospitals.
• Resection margin biopsies were taken post-polypectomy to assess completeness.
• Logistic regression analyzed factors influencing incomplete resection.

Main Results:

• 327 polyps in 246 patients were analyzed; 15.9% (54 polyps) had incomplete resection.
• Serrated histology (OR 10.9) and proximal colon location (OR 2.8) were independent risk factors for incomplete removal.
• No significant difference in incomplete resection rates was found between board-certified endoscopists and trainees (14.0% vs. 14.2%).

Conclusions:

• Incomplete polyp resection is common in clinical practice.
• Serrated histology and proximal polyp location are significant risk factors for incomplete resection.
• Endoscopist experience level did not correlate with resection completeness.