Endoscopy 2021; 53(S 01): S76-S77
DOI: 10.1055/s-0041-1724442
Abstracts | ESGE Days
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Saturday, 27 March 2021 11:00 – 11:45 Resect and discard for diminutive polyps: Where do we stand? Room 6

Advanced Histology In Diminutive And Tiny Colorectal Polyps: Prevalence And Clinical Implications For The Resect And Discard Strategy

A Rossell
1   Universidad Internacional de Catalunya, Sant Cugat del Vallès, Spain
,
C Mármol
2   Althaia, Xarxa Assistencial Universitària de Manresa, Aparato Digestivo, Manresa, Spain
,
A Arnau
3   Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Spain
,
N Ascón
3   Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Spain
,
J da Costa
3   Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Spain
,
I Puig
3   Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Spain
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    Aims Both European and American guidelines suggest that, under strictly controlled conditions, optical diagnosis can replace histopathological diagnosis in diminutive colorectal polyps (resect and discard strategy). However, the low, but not negligible, prevalence of advanced histology has prevented its wide implementation. Moreover, in Eastern countries, a higher prevalence of submucosal invasion has been found in non-polypoid diminutive lesions. The main aim is to compare the prevalence of advanced histology in diminutive and tiny (≤3mm) polyps in order to find a safer threshold.

    Methods Prospective, observational, cross-sectional unicenter study based on the registry of the bowel cancer screening program based on positive FIT.

    Results 8816 lesions were found in 3508 patients. 3403 (38.6 %) lesions were tiny polyps and 5456 (61.9 %) were diminutive. The prevalence of advanced histology was lower in tiny polyps when compared to diminutive ones (1.33 % vs. 2.14 % p< 0.001). When subanalyses were performed, the number of lesions with HGN, villous adenoma with LGN and serrated lesions with dysplasia were less frequent in tiny polyps compared to diminutive ones (0.18 % vs. 0.37 %,p < 0.001; 0.62 % vs. 0.97 %, p< 0.001 and 0.53 % vs. 0.80 %, p< 0.001, respectively). In tiny polyps, histology was unavailable in 275 lesions (8,1 %) and showed normal mucosa in 206 (6.1 %).

    Conclusions The prevalence of advanced histology was lower in tiny polyps when compared to diminutive ones. The histology process failed to diagnose up to 14 % of tiny polyps. Further studies should address whether the resect and discard strategy is safer in tiny polyps than in diminutive ones and whether it is more accurate than the histology process.

    Citation: Rossell A, Mármol C, Arnau A et al. OP185 ADVANCED HISTOLOGY IN DIMINUTIVE AND TINY COLORECTAL POLYPS: PREVALENCE AND CLINICAL IMPLICATIONS FOR THE RESECT AND DISCARD STRATEGY. Endoscopy 2021; 53: S76.


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    Publication History

    Article published online:
    19 March 2021

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