PTH-054 Is Time Allocated for Colonoscopic Endoscopic Mucosal Resection Enough?


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Abstract

IntroductionColorectal cancer is the third commonest cancer in the United Kingdom with 35000 patients newly diagnosed per annum Evidence has shown that resection of adenomatous colonic polyps decreases the occurrence of malignancy by upto 90%. Endoscopic mucosal resection of polyps has been very effective in removing polyps.MethodsA retrospective case study of lower GI EMR procedures done by a single endoscopist (colonoscopy/ sigmoidoscopy) at a district general hospital from September 2012 and January 2013 was performed. The data was extracted from endobase reporting system.Data collected included size, location and morphology of polyp. Procedural data collected included type of EMR and procedural time.Results95 EMRs were included in the study. 1 unit time point was assumed to be 15 min. Procedures were allocated between 2 and 4 units.All the procedures were performed by a consultant gastroenterologist with experience in EMRS. The mean time for 95 procedures was 52 min, whilst the mean allocated time was 43 min. There was a significant correlation between the time taken to complete EMR polypectomy and age (mean age = 66.6 years, p = 0.02 and polyp size (mean diameter = 25.3 mm) p < 0.0001.Morphology of the polyps did not cause significant variation in time taken (sessile/flat-elevated Vs semi-pedunculated/pedunculated: mean duration = 51 mins vs. 54 mins mean time difference = 3 mins p = 0.28.Piecemeal-EMR (p-EMR) was longer than en-bloc EMR (mean duration = 63 vs 48 min, mean difference = 14 min, p < 0.0022.Sigmoidoscopy EMR (n = 52) was not significantly longer than colonoscopy EMR (n = 43) (mean times: 53 vs 50 min mean difference = 3 min p = 0.28).Removal of >1 polyps (n = 74) was not significantly longer than that for 1 polyp (n = 21) (Mean time: 53 vs 46 min, mean difference = 7 min p = 0.1115).ConclusionThe time taken for endoscopic mucosal resection of colonic polyps did not exceed the allocated significantly. The factors that affected the duration significantly were age of the patient and size of the polyp. Piecemeal EMR was also associated with longer duration than enbloc- EMR.These factors should be taken into consideration when booking patients for planned endoscopic resection of colonic polyps.Disclosure of InterestNone Declared.

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