Aims To assess how aspects of a procedure associate with reporting of flat and protruded lesions, according to Paris classification.
Methods The development of the European Colonoscopy Quality Investigation (ECQI) Group questionnaire has been previously described (UEGW 2015 and 2016). We analysed data collected between 2/6/16 and 30/4/18.
Results Of 6445 procedures, 2621 reported a polyp in at least one segment (40.7%). Protruded lesions were reported in 2160 procedures and flat lesions in 692 procedures.
Use of high-definition (HD) equipment significantly increases reporting of both flat lesions (13.2% vs 5.5%, p< 0.0001) and protruded lesions (35.8% vs 23.6%, p< 0.0001). Chromoendoscopy was increasingly used when both flat lesions (23.4% vs 7.9%, p< 0.0001) and protruded lesions (61.4% vs 27.2%, p< 0.0001) were reported. The use of assistive technology significantly increases flat lesion reporting (21.3% vs 10.3%, p< 0.0001). Assistive technology does not influence reporting of protruded lesions (p=0.712).
The reporting of flat (p=0.019) and protruded (p=0.015) lesions varies according to the time of day the procedure was performed. Flat lesion reporting was highest in the morning (07:00-11:59): 13.9% vs 11.3% afternoon (12:00-17:59) vs 8.4% evening (18:00-19:59). Conversely, protruded lesion reporting was higher in the evening and afternoon than morning: morning 30.1% vs afternoon 33.8% vs evening 39.2%.
Conclusions The reporting of both flat and protruded lesions was improved by use of HD equipment or chromoendoscopy. Assistive technology improves detection of flat but not protruded lesions. Reporting of flat lesions is higher in the morning, while protruded lesions are more commonly reported in the afternoon and evening.
Tab. 1
Frequency of flat lesions, according to Paris classification, per colon segment
|
Right
|
Transverse
|
Left
|
Any Segment
|
|
Flat elevation lesion: flat elevation of mucosa 0-lla/flat elevation with central depression 0-lla/c
|
296/15
|
161/9
|
280/23
|
597/46
|
|
Flat lesion: flat mucosal change 0-llb
|
24
|
11
|
17
|
46
|
|
Flat lesion: mucosal depression 0-llc/mucosal depression with raised edge 0-llc/lla
|
8/7
|
0/2
|
4/8
|
11/17
|
