Gut Liver.  2015 Jan;9(1):66-72. 10.5009/gnl13330.

Risk Factors for Incomplete Polyp Resection during Colonoscopic Polypectomy

• Lee SP
• Sung IK
• Kim JH
• Lee SY
• Park HS
• Shim CS

• KMID: 2380784
• DOI: http://doi.org/10.5009/gnl13330

Abstract

BACKGROUND/AIMS
Colonoscopic polypectomy is highly efficient in preventing colorectal cancer, but polyps may not always be completely removed. Improved knowledge of the risk factors for incomplete polyp resection after polypectomy may decrease the cancer risk and additional costs. The aim of this study was to investigate the conditions that can cause incomplete polyp resection (IPR) after colonoscopic polypectomy.
METHODS
A total of 12,970 polyps that were removed by colonoscopic polypectomy were investigated. Among them, we identified 228 cases with a positive resection margin and 228 controls with a clear resection margin that were matched for age, gender, and polyp size. We investigated the location, morphology, and histological type of the polyps and evaluated the skills of the endoscopist and assisting nurse.
RESULTS
Multivariate analysis revealed that the polyps, which were located in the proximal part of the colon and rectum, were at significant risk of IPR. Histologically, an advanced polyp and an inexperienced assistant were also independent risk factors for IPR.
CONCLUSIONS
Polypectomy should be performed more carefully for polyps suspected to be cancerous and polyps located in the proximal part of the colon or rectum. A systematic training program for inexperienced assistants may be needed to decrease the risk of IPR.

Keyword

Colonic polyps; Colonoscopic polypectomy; Adenomatous polyps; Interval colorectal cancer; Polypectomy

MeSH Terms

Adult
Aged
Aged, 80 and over
Case-Control Studies
Clinical Competence
Colon/pathology/surgery
Colonic Polyps/pathology/*surgery
*Colonoscopy
Female
Humans
Male
Middle Aged
Retrospective Studies
Risk Factors
Treatment Failure