Post written by Lonne W.T. Meulen, MD, from the Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The NetherlandsGROW, School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
Our study aimed to provide insight into the quality of endoscopic treatment of large (≥20 mm), nonpedunculated colorectal polyps. Therefore, we evaluated outcomes in a large cohort of screening colonoscopies.
Endoscopic resection of large, nonpedunculated colorectal polyps is technically challenging and associated with a substantial risk of recurrence. With these LNPCPs comprising a significant amount of care within screening programs, quality of care for these lesions is of great importance. Although expert centers have reported their outcomes of endoscopic mucosal resection (EMR) on LNPCPs, little is known regarding these outcomes in a nonexpert setting. Evaluation of outcomes in this nonexpert setting could provide us more insight and contribute to optimizing care for patients with large colorectal polyps.
With current evidence on quality of EMR of LNPCPs in expert settings as a benchmark, our study showed that quality parameters for endoscopic resection of LNPCPs are not reached in a nonexpert settings, especially in ≥30 mm polyps. Quality of large polypectomy seems to be associated with high exposure to and the level of experience in endoscopic resection of LNPCPs. Therefore, endoscopic resection of large polyps could benefit from additional training, quality monitoring, and centralization either within or between centers.
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