Abstract
Accurate measurement of polyp size during colonoscopy is crucial. The usefulness of cap-assisted colonoscopy and external grid application on monitor (gCAP) was evaluated for polyp size measurement in this 3-year, single-center, single-blind, randomized trial. Using the endoscopic forceps width as reference, the discrepancy percent (DP), error rate (ER), and measurement time were compared between gCAP and visual estimation (VE) after randomization. ER was calculated within a 20% and 33% limit. From the 111 patients, 280 polyps were measured. The mean polyp sizes were 4.0 ± 1.7 mm and 4.2 ± 1.8 mm with gCAP and VE, respectively (p = 0.368). Compared with that by the forceps method, DP was significantly lower in the gCAP group than in the VE group. Moreover, ER was significantly lower in the gCAP group within its preset limit. The measurement time was 4 s longer in the gCAP group than in the VE group (8.2 ± 4.8 s vs. 4.2 ± 1.5 s; p < 0.001). However, the forceps method lasted 28 s longer than the others. On subgroup analysis by size, gCAP was more accurate for polyp size ≥ 5 mm. The gCAP method was more accurate for polyp size measurement than VE, especially for polyps ≥ 5 mm, and was more convenient than the forceps method.
Highlights
Accurate measurement of the polyp size is crucial for screening and surveillance in colorectal cancer [1,2]
Colonic polyp size is a risk factor for colorectal cancer, with large polyps associated with a greater risk than smaller ones
Results total of 280 polyps were measured in the 111 patients
Summary
Accurate measurement of the polyp size is crucial for screening and surveillance in colorectal cancer [1,2]. Colonic polyp size is a risk factor for colorectal cancer, with large polyps associated with a greater risk than smaller ones. Incorrect measurement of a polyp size can affect its follow-up interval [3]. Pathologic size measurement has been the “gold standard”, polyp size is usually measured by subjective visual estimation (VE). Accurate measurement of polyp size during colonoscopy is pivotal. Polyps are measured using various tools, such as an endoscopic ruler, forceps, a graduated needle, and a calibrated colonic cap, but these tools can be time-consuming and expensive [9,10,11,12]. The grid paper was placed on the monitor for more
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