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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(12): E1555-E1561
DOI: 10.1055/a-1959-6012
Original article

Frequency and nature of endoscopic and pathologic errors leading to referral for endoscopic resection to a tertiary center

Rachel E. Lahr
1   Division of Gastroenterology/Hepatology, Indiana University School of Medicine Indianapolis, Indiana, United States
,
Connor D. McWhinney
1   Division of Gastroenterology/Hepatology, Indiana University School of Medicine Indianapolis, Indiana, United States
,
Oscar W. Cummings
2   Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States
,
Douglas K. Rex
1   Division of Gastroenterology/Hepatology, Indiana University School of Medicine Indianapolis, Indiana, United States
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Abstract

Background and study aims We anecdotally encounter cases where referring endoscopists made errors in endoscopic interpretation of a colorectal lesion, sometimes combined with pathology errors at the referring centers, resulting in referral to our center for endoscopic resection. In this paper, we describe the frequency and nature of endoscopic and pathology errors leading to consultation for endoscopic resection.

Patients and methods Review of 760 consecutive referrals to our center over a 26-month interval.

Results In total, 28 (3.7 %) of all referred patients had ≥ 1 lesion that did not require any resection after investigation. There were 12 cases (1.6 % of all referrals) involving errors by both the referring endoscopist and the pathologist at the referring center. Errors commonly involved the ileocecal valve, lipomas, and mucosal prolapse changes. There were 15 additional referrals (2.0 % of all referrals) where no neoplastic lesion was identified at our center and either no biopsy was taken at the referring center (n = 9 patients, 10 lesions), the patient was referred although biopsy showed no neoplasia (n = 6), or the referring doctor correctly interpreted the lesion (lipoma), but the outside pathologist incorrectly reported adenoma (n = 1).

Conclusions Endoscopists at tertiary centers should expect referrals to clarify the nature of colorectal lesions as neoplastic or non-neoplastic. Community endoscopists with equivocal endoscopic findings and unexpected or equivocal pathology results can consider pathology review at their center or at an expert center before referral for endoscopic or surgical resection.

Supplementary material



Publication History

Received: 08 June 2022

Accepted after revision: 11 October 2022

Accepted Manuscript online:
12 October 2022

Article published online:
15 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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