P1757 - Feasibility and Safety of Same-Session Endoscopic Mucosal Resection of Large Colon Polyps During Screening, Surveillance, or Diagnostic Colonoscopies: A Retrospective Study

Fnu Varnika, MBBS¹, Shashank Garg, MD, MS^2
1Arkansas Gastroenterology, San Jose, CA; ²Arkansas Gastroenterology, Little Rock, AR

Introduction: Large colon polyps ( > 1 cm) found commonly during screening or post-polypectomy surveillance colonoscopies may require endoscopic mucosal resection (EMR). Traditionally another colonoscopy is done to perform the EMR. We looked at feasibility and safety of same session EMR of large colon polyps during screening, post-polypectomy surveillance or diagnostic colonoscopies.

Methods: This was a quality improvement project performed from colonoscopy quality data collected for participation in GIQuIC registry. All patients undergoing EMR during screening, post-polypectomy surveillance or diagnostic colonoscopies from July 1
^st

2021 to April 11
^th

, 2023 were included in the study. Technique and equipment used for EMR was determined by the gastroenterologist performing the procedure based on location, size and morphology of the polyp. Demographics, BMI, ASA class, procedure details (indication, type of sedation, withdrawal time), colonoscopy findings (number, size and location of polyps, details of the polyp removed with EMR) and pathology reports were obtained. Data analysis was performed using SAS (version 9.4, SAS Institute Inc., NC, USA).

Results: A total of 204 patients underwent EMR of 233 colon polyps in the same colonoscopies performed for screening, post-polypectomy surveillance or diagnostic purposes during the study period. Patient demographics and certain procedure related details are provided in table 1. Median withdrawal time was 24 minutes (IQR 20-30.5 min). Median size of the polyps resected with EMR was 18 mm (IQR 15-20 mm). Median number of small (< 1 cm) polyps removed in each procedure was 3 (IQR 2-6). 100 (42.92%) of the large polyps were removed with cold EMR and 133 (57.08%) large polyps were removed with cautery. 195 (83.69%) polyps were removed en-bloc and 38 (16.31%) were removed piecemeal. 5 (2.15%) patients had immediate post polypectomy bleeding requiring hemostasis and one (0.43%) patient had delayed post-polypectomy bleeding.

Discussion: EMR for large colon polyps can be performed safely and effectively during colonoscopies being performed for colon cancer screening, post-polypectomy surveillance or diagnostic purposes. Such polyps should be removed only if the EMR can be performed without causing significant delays in the upcoming procedures or an overt increase in the risk of procedure related complications by physicians and endoscopy staff trained in this technique.


Disclosures:


Fnu Varnika, MBBS¹, Shashank Garg, MD, MS². P1757 - Feasibility and Safety of Same-Session Endoscopic Mucosal Resection of Large Colon Polyps During Screening, Surveillance, or Diagnostic Colonoscopies: A Retrospective Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.