Su1352 Clinical Impact of a Discard Strategy Based on FICE and Magnifying Colonoscopy for the In Vivo Histology Prediction of Small Colorectal Polyps

Abstract

The current practice is to retrieve all colorectal polyps removed on colonoscopy for histopathological evaluation. A recent proposal states that if an endoscopist could make a confident in-vivo diagnosis, small colorectal polyps removed by polypectomy could not be retrieved for histopathology, so called Detect Inspect Characterize Resect and Discard strategy (Ignjatovic et al Lancet Oncol 2009). This has been recognized as an important initiative by the American Society for Gastrointestinal endoscopy (ASGE). In order to help in defining the standards which have to be met for any technology to be used for in-vivo diagnosis as a replacement for conventional histological examination, we performed a prospective evaluation on the accuracy of FICE and magnifying colonoscopy for in vivo histology prediction for polyps less than 7mm in size and assessed the clinical impact of a DISCARD strategy.