PTH-041 Large (<4 cm) and giant (≥4 cm) colorectal polyps: comparison of piecemeal resection outcomes

Abstract

Introduction Piecemeal Endoscopic Mucosal Resection (p-EMR) is a standard and safe endoscopic technique for resection of large colorectal polyps (>2 cm). Limited data are available regarding p-EMR of giant polyps (>4 cm). Method A prospective study recording short and long-term outcomes after p-EMR for colorectal polyps > 2 cm between Jan 2010 and August 2012 was conducted. We compared two cohorts of patients: group-A with large polyps (2 to Results Group-B patients were older than group-A patients (mean 70.6 vs. 67.8 yrs, p = 0.01) and were more likely to have come from a tertiary referral source (p = 0.05). Large polyp referrals were almost twice as frequent as giant polyp referrals (218 vs. 123, p Endoscopic excision was complete in 89% in large (median time 18min) and in 70% in giant groups (median time 38min). All large polyps were excised in one session, whilst 4% of giant polyps required more than one session. Incomplete submucosal lift (46% vs 63%, p = 0.002) and difficult polyp position (45% vs 63%, p Conclusion Piecemeal resection is a safe and efficacious modality for the resection of colorectal polyps >4 cm. However, these giant polyps more often require spiral snare or hybrid resection techniques and their higher adenoma recurrence rate post p-EMR may dictate shorter surveillance intervals. Disclosure of interest None Declared.