P3035 - Impact of Different Interventions Used in Polypectomy and Endoscopic Mucosal Resection on Polyp Recurrence: A Pilot Study

Aastha Bharwad, MD, Lawrence Zhou, MD, Rhythm Vasudeva, MD, Hayrettin Okut, PhD, Rosey Zackula, MA, Nathan D. Tofteland, MD, William J.. Salyers, MD, MPH
University of Kansas School of Medicine, Wichita, KS

Introduction: Current literature has studied the impact of Argon Plasma Coagulation (APC) on polyp recurrence following polypectomy and Endoscopic Mucosal Resection (EMR). While studies exist to evaluate endoscopic clip placement (ECP) to prevent polypectomy bleeding, to our best knowledge the effect of ECP on polyp recurrence has not yet been studied. With our retrospective study, we compared en-bloc polypectomy and EMR with or without additional interventions including APC, ECP, and APC + ECP for polyp recurrence.

Methods: Ours is a pilot study extracting data from a random 100 patient charts from a total of 1284 patients at KU- Gastroenterology Clinic, Wichita. Inclusion criteria included adults (≥18 to 89 years old) who underwent polypectomy or EMR with or without additional interventions (APC/ ECP/ APC + ECP) as part of clinical care between 07/01/2011-01/01/2023. Patients without follow-up colonoscopies were excluded. Patients were followed until outcome was observed or the last colonoscopy. Chi-square test was used to compare the variables. Appropriate ICD-10 codes were used, and statistical significance was set at 0.05.

Results: Out of 100 patient charts reviewed, 6 were noted to not have a follow-up colonoscopy. The mean age of subjects was 65.8 years, mean BMI was 31.5 kg/m2, 51 were females, and 87 were white. A total of 15 patients had a polyp recurrence, out of which 96% were identified with a follow-up colonoscopy within 12 months. Amongst polyp characteristics, polyp size of ≥20mm (41.9%), polyp morphology of villous or tubulo-villous (42.8%) and serrated adenoma/lesion (40%), piecemeal resection (38.1%), had a high recurrence of polyps on repeat colonoscopy. Amongst interventions done during EMR, APC (45.5%) and APC with ECP (66.7%) had the greatest polyp recurrence when compared to ECP (22.7%) and no intervention (5.2%), p = 0.001. Having more than 1 clip placement was linked with a statistically significant higher recurrence of polyps (42.9% vs 8.3%).

Discussion: Our study highlights important variables linked with polyp recurrence. Interventions involving APC demonstrated a higher polyp recurrence compared to those involving ECP. Amongst ECP, placement of > 1 clip was associated with an increased risk of recurrence. Polyp characteristics, including size, morphology, and mode of resection, could be important confounding variables. Our pilot study sets an important premise to further assess these associations.


Disclosures:


Aastha Bharwad, MD, Lawrence Zhou, MD, Rhythm Vasudeva, MD, Hayrettin Okut, PhD, Rosey Zackula, MA, Nathan D. Tofteland, MD, William J.. Salyers, MD, MPH. P3035 - Impact of Different Interventions Used in Polypectomy and Endoscopic Mucosal Resection on Polyp Recurrence: A Pilot Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.