PMO-223 Tattooing of suspicious colonic lesions at colonoscopy: is adherence to local protocol better if identified through the Bowel Cancer Screening Programme?

Abstract

patients underwent OGDs pre-operatively and for what indication and with what result. Further sub-analysis was performed for each operation type. Results 147 OGDs were done on a total of 116 bariatric surgical patients, with 23 patients having had more than one OGD each. Of these 147 OGDs 44 were pre-operative. 13 (29.5%) OGD referrals were made to investigate anaemia, 12 (27.3%) for pre-surgical screening to investigate existing symptoms of gastric ulceration, and 9 (20.5%) to investigate abdominal pain. The remaining referrals were made for interventional gastric balloon insertions and removals (6¼13.6%) and to investigate symptoms of reflux (3¼6.8%) and dysphagia (1¼2.3%). The majority of patients (50%) were referred prior to having a roux-en-y gastric bypass operation. Most of the pre-operative OGD findings were normal (16¼36.4%), but gastritis (6¼13.6%), hiatal hernias (6¼13.6%), gastric ulceration (2¼4.5%), oesophagitis (1¼2.3%) and duodenitis (1¼2.3%) were noted. Of the 13 patients referred with anaemia, 9 (69.2%) had normal mucosa on OGD, but of the 12 patients who had pre-surgical screening 7 (58.3%) were found to have abnormalities, including a fundic gland polyp and antral erosions. Conclusion Using a selective referral process, only 4% of all bariatric surgery cases performed required preoperative endoscopy. The commonest indication for OGD preoperatively was anaemia and the commonest pathology found was mucosal inflammation (gastritis, oesophagitis and duodenitis).Competing interests None declared. Introduction The Joint Advisory Group on gastrointestinal endoscopy and the National Bowel Cancer Screening Programme (BCSP) have published guidelines on the tattooing of malignant and suspicious lesions at colonoscopy. Our endoscopy department has a local protocol for the tattooing of these lesions based on these guidelines. The BCSP has led to an increase in the number of colonoscopies performed and the number of lesions identified. Aim To assess adherence to a local protocol in a single endoscopy unit and identify if lesions identified through the BCSP are more likely to be tattooed than lesions identified for other reasons. Methods A retrospective review of a prospectively maintained database was performed. All colonoscopies performed between 1 April 2010 and 31 March 2011 were reviewed and screening cases identified. Results 4023 colonoscopies were performed, 307 (8%) as part of the BCSP. Malignancy or polyps were identified in 192 (63%) of BSCP colonoscopies compared to 26% (958/3716) of non-BCSP colonoscopies. Significantly more polyps and malignancies were identified during BCSP colonoscopies than non-BCSP colonoscopies (p<0.0001 PMO-223 TATTOOING OF SUSPICIOUS COLONIC LESIONS AT COLONOSCOPY: IS ADHERENCE TO LOCAL PROTOCOL BETTER IF IDENTIFIED THROUGH THE BOWEL CANCER