A7 the Polyp-Based Resect-and-Discard Strategy

Duong, Adam; Bouin, Mickaël; Leduc, Raymond; Deslandres, Érik; Deshêtres, Annie; Weber, Andrée; Pohl, Heiko; Barkun, Alan N.; Renteln, Daniel von

doi:10.1093/jcag/gwz006.006

Cited by 2 publications

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“…These simplified strategies achieved > 90 % surveillance interval agreement compared to pathology and allowed for providing more patients with surveillance interval planning on the same day as the colonoscopy [19]. Other recent studies have proposed using only number and size of polyps as criteria for surveillance interval assignment [20,21]. This approach was able to achieve a 90 % surveillance interval agreement with pathology in one instance and an 89.3 % agreement in another [20,21].…”

Section: Questionsmentioning

confidence: 91%

“…This approach was able to achieve a 90 % surveillance interval agreement with pathology in one instance and an 89.3 % agreement in another [20,21]. More than 80 % of patients could be provided with a surveillance interval on the same day using such an approach [20,21]. These alternative approaches thus appear promising even though endoscopists tended to prefer shorter intervals [20].…”

Section: Questionsmentioning

confidence: 95%

“…Other recent studies have proposed using only number and size of polyps as criteria for surveillance interval assignment [20,21]. This approach was able to achieve a 90 % surveillance interval agreement with pathology in one instance and an 89.3 % agreement in another [20,21]. More than 80 % of patients could be provided with a surveillance interval on the same day using such an approach [20,21].…”

Section: Questionsmentioning

confidence: 99%

See 2 more Smart Citations

Uptake and barriers for implementation of the resect and discard strategy: an international survey

Willems¹,

Djinbachian²,

Ditisheim³

et al. 2020

Endosc Int Open

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Background and study aims Optical real-time diagnosis (= resect-and-discard strategy) is an alternative to histopathology for diminutive colorectal polyps. However, clinical adoption of this approach seems sparse. We were interested in evaluating potential clinical uptake and barriers for implementation of this approach. Methods We conducted an international survey using the “Google forms” platform. Nine endoscopy societies distributed the survey. Survey questions measured current clinical uptake and barriers for implementing the resect-and-discard strategy, perceived cancer risk associated with diminutive polyps and potential concerns with using CT-colonography as follow-up, as well as non-resection of diminutive polyps. Results Eight hundred and eight endoscopists participated in the survey. 84.2 % (95 % CI 81.6 %–86.7 %) of endoscopists are currently not using the resect-and-discard strategy and 59.9 % (95 % CI 56.5 %–63.2 %) do not believe that the resect-and-discard strategy is feasible for implementation in its current form. European (38.5 %) and Asian (45 %) endoscopists had the highest rates of resect-and-discard practice, while Canadian (13.8 %) and American (5.1 %) endoscopists had some of the lowest implementation rates. 80.3 % (95 % CI 77.5 %–83.0 %) of endoscopists believe that using the resect-and-discard strategy for diminutive polyps will not increase cancer risk. 48.4 % (95 % CI 45.0 %–51.9 %) of endoscopists believe that leaving diminutive polyps in place is associated with increased cancer risk. This proportion was slightly higher (54.7 %; 95 % CI 53.6 %–60.4 %) when asked if current CT-colonography screening practice might increase cancer risks. Conclusion Clinical uptake of resect-and-discard is very low. Most endoscopists believe that resect-and-discard is not feasible for clinical implementation in its current form. The most important barriers for implementation are fear of making an incorrect diagnosis, assigning incorrect surveillance intervals and medico-legal consequences.

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