Use of a novel polyp “ruler snare” improves estimation of colon polyp size

Kaz, Andrew M.; Anwar, Asma; O’Neill, Darby Robinson; Dominitz, Jason A.

doi:10.1016/j.gie.2015.08.082

Cited by 30 publications

(36 citation statements)

References 15 publications

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“…In 63% of these polyps, a size-difference of at least 33% was detected between in situ and postfixation measurements, leading to inappropriate surveillance recommendations in over a third of the cases, regardless of histology and the number of detected polyps. Multiple studies show that in situ measurements differ significantly from postfixation measurements, but there are few studies assessing interobserver variation of in-situ measurements [10][11][12][13]. Most of these interobserver studies have been performed in colon models [11,12] or on video fragments [10,13] and do not specifically address large polyps.…”

Section: Introductionmentioning

confidence: 99%

“…Multiple studies show that in situ measurements differ significantly from postfixation measurements, but there are few studies assessing interobserver variation of in-situ measurements [10][11][12][13]. Most of these interobserver studies have been performed in colon models [11,12] or on video fragments [10,13] and do not specifically address large polyps. Since the proportion of advanced histology increases rapidly with increasing polyp sizes [14], an evaluation of in-situ measurements of large polyps is warranted.…”

Section: Introductionmentioning

confidence: 99%

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Reproducibility and accuracy of visual estimation of polyp size in large colorectal polyps

et al. 2019

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Background: Previous studies indicate that visual size estimation (in situ) of polyp size tends to differ from postfixation measurements, which effects allocation to surveillance intervals. Little is known about interobserver variation of in-situ measurements of large polyps. The primary objective was to assess interobserver variation of in situ measurements of large colorectal polyps. Secondary objectives were the agreement of in situ measurements with postfixation measurements, and the agreement on detection of !20 mm polyps between these measurements. Material and methods: Interobserver variability of in situ polyp size measurements was assessed between a diagnostic colonoscopy and the secondary therapeutic colonoscopy by dedicated endoscopists, in patients that were referred for an advanced polypectomy. After excision pre-and postfixation polyp sizes were measured with a ruler in three dimensions. Results: A total of 40 patients, with 45 polyps, were included in the study. The average difference between the two in situ measurements was 2.4 mm (95% confidence interval (CI): À0.4-5.2). The differences between the first in situ, second in situ and pre-fixation measurement in comparison to postfixation measurements were 1.8 mm (95% CI: À1.2-4.9), 0.1 mm (95% CI: À1.5-1.8) and 1.0 mm (95% CI: À0.2-2.2). Cohen's Kappa on detection of !20 mm polyps in agreement with postfixation measurements was 0.65 in the primary and 0.88 in the secondary in situ measurements. Conclusion: This study shows a variation between in situ size measurements of large polyps. Improvements in daily clinical routines can be made by using an instrument to compare polyp size with and refraining from rounding sizes up or down. A randomized controlled trial assessing which instruments should be used for in-situ measurements of large polyps is warranted, in order to optimize size measurements of large colorectal polyps.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reproducibility and accuracy of visual estimation of polyp size in large colorectal polyps

et al. 2019

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“…As réguas antropométricas são comuns na área da saúde, utilizadas para diagnósticos cognitivos-mecânicos (ARANHA et al 2017); para auxiliar técnicas forenses (BARNS; KRUGER; TENNANT, 2016); para mensurar anomalias em vísceras (KAZ et al 2016); para acompanhar redução de feridas (SHAH et al, 2013); para avaliar as taxas de crescimento em crianças (CLOUTIER et al, 2013); para analisar a dilatação cervical (NIZARD et al, 2009); para estudar a flexibilidade em cifose torácica (KHALKHALI et al, 2016); dentre outros usos.…”

Section: Introductionunclassified

Pré-diagnóstico da esquistossomose no semiárido: régua antropométrica e aplicativo colaborativo

et al. 2019

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A esquistossomose é uma doença tropical negligenciada pertencente ao grupo das infecções helmínticas, causada pelo parasita do gênero Schistosoma, que tem afetado pessoas em todo o mundo. No Brasil, cem milhões de casos foram registrados nos últimos trinta e sete anos. Os objetivos desta dissertação foram detectar uma zona pré-diagnóstica para esquistossomose na relação entre o índice de massa corporal e a circunferência abdominal de indivíduos suspeitos de terem essa doença e propor uma ferramenta e um aplicativo colaborativo que terá também um uso educacional. Os procedimentos metodológicos seguiram seis passos: i) a alimentação do banco de dados; ii) a modelagem estatística; iii) a sistematização da árvore de decisão diagnóstica pelas variáveis; iv) a construção de uma régua antropométrica e de um aplicativo colaborativo; v) a aplicação das ferramentas construídas; e, vi) a análise quali-quantitativa. As ferramentas construídas participaram de maneira eficiente para o pré-diagnóstico da esquistossomose, com a redução da passagem de pacientes da fase aguda para fases crônica e pós-crônica, contribuindo com o paciente, no sentido de qualidade e no tempo do tratamento, e com a redução de gastos pelo sistema público de saúde. O mesmo foi relatado para as atividades de ensino e aprendizagem, a utilização das ferramentas por docentes e agentes de saúde em seus ambientes de laboro pôde apresentar de forma lúdica a aplicação da árvore de decisão para o pré-diagnóstico da doença em questão, a resultar na apropriação do conteúdo e da práxis pelo aprendiz.

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“…But, besides being time-consuming, some authors showed that there is still a great interobserver variability [6,10,19]. Several other devices to minimize endoscopists' error have been described, such as a graduated ruler [22], a calibrated hood for use in cap-assisted colonoscopy [23,24], a linear probe [25], and a virtual tape measure containing a laserline emitter [26]. Some of the devices described are prototypes, used only in investigation settings and tested in artificial or animal models, and others are not widely available or were not generally adopted in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Variation between Pathological Measurement and Endoscopically Estimated Size of Colonic Polyps

Atalaia-Martins¹,

Marcos²,

Leal³

et al. 2018

GE Port J Gastroenterol

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Background and Aims: Accurate determination of colonic polyp size is vital to an appropriate surveillance. The main aim of this study was to evaluate variation between the polyp size reported by the endoscopist and its pathological measurement. Methods: A retrospective analysis of all colonic adenomatous polyps resected in a 12-month period was performed at our center. Endoscopic and pathological size for each polyp were compared, and overestimation rates, underestimation rates, and endoscopic-pathological variation (EPV) were calculated. Results: Among the 573 polyps that were included, the mean endoscopic and pathological sizes were 8.00 and 6.66 mm, respectively. The most frequent error, in 62.1%, was overestimation by the colonoscopist. Overestimation and EPV were associated with resection technique (higher in endoscopic mucosal resection and smaller with biopsy forceps) and colonoscopist. They were not associated with years of experience in colonoscopy. Overestimation was more frequent in larger polyps. Conclusions: Our study shows significant discordance between endoscopic and pathological size of colonic polyps with a clear tendency for endoscopic overestimation. Larger polyps are more difficult to accurately assess than smaller ones. This propensity for error was not related to colonoscopist’s years of experience and seems to be an individual tendency.

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Use of a novel polyp “ruler snare” improves estimation of colon polyp size

Cited by 30 publications

References 15 publications

Reproducibility and accuracy of visual estimation of polyp size in large colorectal polyps

Reproducibility and accuracy of visual estimation of polyp size in large colorectal polyps

Pré-diagnóstico da esquistossomose no semiárido: régua antropométrica e aplicativo colaborativo

Variation between Pathological Measurement and Endoscopically Estimated Size of Colonic Polyps

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