Risk Factors for Incomplete Polyp Resection during Colonoscopic Polypectomy
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Background/Aims: Colonoscopic polypectomy is highly efficient in preventing colorectal cancer, but polyps may not always be completely removed. Improved knowledge of the risk factors for incomplete polyp resection after polypectomy may decrease the cancer risk and additional costs. The aim of this study was to investigate the conditions that can cause incomplete polyp resection (IPR) after colonoscopic polypectomy. Methods: A total of 12,970 polyps that were removed by colonoscopic polypectomy were investigated. Among them, we identified 228 cases with a positive resection margin and 228 controls with a clear resection margin that were matched for age, gender, and polyp size. We investigated the location, morphology, and histological type of the polyps and evaluated the skills of the endoscopist and assisting nurse. Results: Multivariate analysis revealed that the polyps, which were located in the proximal part of the colon and rectum, were at significant risk of IPR. Histologically, an advanced polyp and an inexperienced assistant were also independent risk factors for IPR. Conclusions: Polypectomy should be performed more carefully for polyps suspected to be cancerous and polyps located in the proximal part of the colon or rectum. A systematic training program for inexperienced assistants may be needed to decrease the risk of IPR.
Abstract
Background/Aims: Colonoscopic polypectomy is highly efficientin preventing colorectal cancer, but polyps may notalways be completely removed. Improved knowledge of therisk factors for incomplete polyp resection after polypectomymay decrease the cancer risk and additional costs. The aimof this study was to investigate the conditions that can causeincomplete polyp resection (IPR) after colonoscopic polypectomy. Methods: A total of 12,970 polyps that were removedby colonoscopic polypectomy were investigated. Amongthem, we identified 228 cases with a positive resection marginand 228 controls with a clear resection margin that werematched for age, gender, and polyp size. We investigated thelocation, morphology, and histological type of the polyps andevaluated the skills of the endoscopist and assisting nurse. Results: Multivariate analysis revealed that the polyps, whichwere located in the proximal part of the colon and rectum,were at significant risk of IPR. Histologically, an advancedpolyp and an inexperienced assistant were also independentrisk factors for IPR. Conclusions: Polypectomy should beperformed more carefully for polyps suspected to be cancerousand polyps located in the proximal part of the colonor rectum. A systematic training program for inexperiencedassistants may be needed to decrease the risk of IPR.
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