PWE-066 Endoscopic Versus Histological Assessment Of Colonic Polyp Size. (9th June 2014)

• Record Type: Journal Article
• Authors: Gashau, WJ; Kong, C; Lee, HY; Willert, R
• Is Part Of: Gut. Volume 63(2014)Supplement 1
• Page Start: A152
• Page End: A152
• Publication Date: 2014-06-09
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2014-307263.326
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Introduction: Colonic polyp size is a factor in determining management and prognosis of patients. Polyp diameters greater than 9 mm require ongoing colonoscopic surveillance. 1 Accurate endoscopic estimation of polyp size can be affected by depth perception and parallax errors. We compared endoscopic versus histological size assessments to determine if accurate estimation was operator-dependent. Methods: Symptomatic and asymptomatic (bowel screening) patients were identified from hospital databases. Endoscopic and histological polyp diameters were reviewed. Agreement levels between these were analysed by deriving intraclass correlation coefficient (ICC) using SPSS software (Version 20). Results: Sixteen colonoscopists were included: 5 bowel screening, 7 non-bowel screening and 4 trainees. Five hundred and ten polyps (n = 510) were found among 299 patients (186 males, 104 females). Two hundred eighteen polyps were enbloc resected, retrieved whole and analysed. Overall accuracy of polyp size assessment was good (ICC > 0.70) with variability between skill levels (Table 1 ). Accuracy was best among polyps ≥20 mm diameter (ICC 0.99, p < 0.001); all removed by bowel screening colonoscopists. Polyps between 8 to 12 mm demonstrated poor correlation (ICC (absolute agreement) 0.535, P = 0.002). Conclusion: While endoscopic estimation of polyp diameter is accurate, variability exists. Estimations are more accurate among bowel screening endoscopists suggesting experience and/or colonoscopy workload contribute to this skill. Poor diameter estimations among polyps 8–12 mm has implications for polyp surveillance intervals. Standardising diameter using against closed or open biopsy forceps (width 2.2 and 8 mm respectively) to optimise accuracy should be used. Reference: 1 Cairns, et al . Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002). Gut 2010;59:666–690 Disclosure of Interest: None Declared.