Introduction Colon polyp size is a critical biomarker for clinical management of colonic polyps. Larger polyps have a greater malignant potential. During colonoscopy, it is important to correctly measure the size of the polyps because of the direct correlation of size with colon cancer.1 During polypectomy, size of the colonic polyps encountered are often gauged by visual estimation or the open forceps method.2 However, some data exists on the questionable reliability of a visual estimate even amongst expert colonoscopists. We aim to compare the estimation of polyp size using the visual estimation of colon polyp with or without the open biopsy forceps technique against actual polyp size measurement by our histopathology department for all polyps >1 cm in size.
Methods A single centre, retrospective analysis using the Unisoft GI auditors software was used to identify patients who have had polypectomies done for polyps >1 cm in size from October 2005 till September 2013. The size of the polyps documented in the endoscopy report was then compared to the lab measured actual polyp size.
Results A total of 39 patients were identified with polyps >1 cm in size who has had polypectomy done. Results are as below:
Conclusion From this study we can conclude that visual estimation with or without the open biopsy forceps technique is completely inaccurate with wide variations between the reported size and the actual size of the polyps when measured in our laboratory. Accurate measurement of colonic polyps is important as inaccuracies can lead to potentially larger polyps not being tattooed and subsequent difficulty in identification during surgery and surveillance. We advocate that the ‘gold standard’ practice of direct measurement of the polyp once excised and outside the body be adopted and the actual size should be documented according to direct measurement.
Gopalswamy N, Shenoy V, Choudhry U et al. Is in vivo measurement of size of polyps during colonoscopy accurate? Gastrointest Endosc. 1997 Dec;46(6):497–502
Rex D, Rabinovitz R. Variable interpretation of polyp size by using open forceps by experienced colonoscopists. Gastrointest Endosc. 2013 Oct 8. pii: S0016–5107(13)02317–1
Disclosure of Interest None Declared.
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