Experience, Outcomes, and Insights on Endoscopic Colonic Polyp Excision: A Retrospective Cohort Study

Area of Science:

• Gastroenterology
• Surgical Oncology
• Public Health

Background:

• Colorectal cancer (CRC) is a significant global health concern, with most cases originating from adenomatous polyps.
• Large colonic polyps (≥10 mm) have a higher risk of malignant progression, necessitating effective removal strategies.

Purpose of the Study:

• To evaluate the safety and efficacy of large polyp excision in a district general hospital setting.
• To analyze patient demographics, polyp characteristics, procedural details, and clinical outcomes of endoscopic polypectomy.

Main Methods:

• Retrospective cohort study of patients undergoing endoscopic polypectomy from 2010 to 2022 at a single NHS trust.
• Data collection included patient age, sex, polyp size and characteristics, and previous polyp removal history.

Main Results:

• 350 participants (64% male, mean age 70) were included. Complications occurred in 2.3% of participants.
• Complications were associated with larger polyp sizes (mean 49.38 mm vs. 44.85 mm), particularly for polyps ≥40 mm, though not statistically significant (p=0.352).

Conclusions:

• Endoscopic excision of large polyps is safe and effective in a district hospital setting.
• While larger polyps (≥40 mm) showed a trend towards increased complications, the procedures remain safe and efficacious.
• Local excision reduces the burden on tertiary and specialized hospitals.