Non-optical polyp-based resect and discard strategy: A prospective clinical study.

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Cancer Screening

Background:

• Current post-polypectomy surveillance relies on pathology results.
• Accurate surveillance intervals are crucial for effective patient management.

Purpose of the Study:

• To assess a novel polyp-based model for determining surveillance intervals.
• This model uses polyp number and size, bypassing pathology for some cases.

Main Methods:

• Prospective enrollment of patients undergoing colonoscopies.
• Comparison of a polyp-based strategy with optical diagnosis and pathology-based guidelines.
• Evaluation of agreement, reduction in pathology needs, and immediate recommendation rates.

Main Results:

• The polyp-based strategy achieved 98.0% agreement with pathology-based surveillance intervals.
• Optical diagnosis showed 95.8% agreement.
• Pathology evaluations reduced by 87.8% with the polyp-based strategy and 70.6% with optical diagnosis.
• Immediate recommendations were provided to 93.7% of patients using the polyp-based strategy.

Conclusions:

• The polyp-based strategy offers high accuracy for surveillance interval assignment.
• This approach substantially decreases the reliance on histopathology.
• It facilitates timely post-colonoscopy recommendations for patients.