LARGE NON-PEDUNCULATED COLORECTAL POLYPS REMOVAL AND RESULTS IN A UK DISTRICT HOSPITAL OVER A 12 MONTHS PERIOD

Aims:

To identify results, pit falls to formulate recommendations based on audit of LNPCP removal over a 12 months period and to compare it with BSG (British Society of Gastroenterology Society) guide lines and to see that it meets recommended BSG standards. Data collection was between Aug 2016 till Aug 2017.

Methods:

A retrospective data collection was conducted of LNPCP removed over a 12 months period 14 different parameters were used for each polypectomy conducted and results were analyzed on MS Excel.

Results:

50 patients had LNPCPs removed during this 12 months duration. The demographic results shows that majority of patients were in there eighties. 56% were female and 44% were male. Majority of polyps were in distal sigmoid and hepatic flexure which constitutes 36%. The majority of the polyps removed were between 2 – 3 cm which makes 36% of total sample size.82% of polyps were removed by hot snare cauterisation.. The majority of indication for colonoscopy was previous polyps and this was 28%. 54% of polyps were completely removed and remaining were piecemeal. 26% of patients received midazolam and 50 mg of Fentanyl.

62% of cases pit pattern was not recorded in the endoscopy report..66% of cases paris classification was not noted. 100% polyps were retrieved. 54% polyps were removed completely. One adverse event was noted which was patient discomfort.66% polyps had histology of tubovillous adenoma with low grade dysplasia. 72% polyps were regarded as complete by histopathologis. No patients were readmitted. 4 patients had adenocarcinoma.

Conclusions:

Pit pattern and paris classification of polyps to be entered religiously to rule out suspicious lesion. Referral pathway to facilitate the management of LNPCP to be developed. Mdt to discuss complex LNPCP. Endoscopist to be highly experienced in standard polypectomy. Primary therapeutic management of LNPCPs to be undertaken in 8 weeks.