Implications of Stable or Increasing Adenoma Detection Rate on The Need for Continuous Measurement

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Room Temperature Water Infusion during Colonoscopy Insertion Induces Rectosigmoid Colon Mucus Production

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Outcomes of Large Colorectal Polyp Endoscopic Resections During Small Audience Live Endoscopy Events with the Endoscopist at Their Home Endoscopy Unit

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Adverse events and residual lesion rate after cold endoscopic mucosal resection of serrated lesions ≥10 mm

Background and Aims Cold endoscopic mucosal resection (EMR) is being increasingly used for large serrated lesions. We sought to measure residual lesion rates and adverse events after cold EMR of large serrated lesions. Methods In a single academic center, we retrospectively examined a database of serrated class lesions ≥ 10 mm removed with cold EMR for safety and efficacy. Results Five hundred and sixty-six serrated lesions ≥10 mm in size were removed from 312 patients. We successfully contacted 223 patients (71.5%) with no reported serious adverse events that required hospitalization, repeat endoscopy, or transfusion. The residual lesion rate per lesion at first follow-up colonoscopy was 18 out of 225 (8%; 95% CI, 5-12.1). Lesions with residual were larger at polypectomy compared with lesions without recurrence (median, 23 mm vs 16 mm, p=0.017). Conclusion Cold EMR appears to be safe and effective for the removal of large serrated lesions

Implications of stable or increasing adenoma detection rate on the need for continuous measurement

Background and Aims Measurement of adenoma detection rate (ADR) is resource intensive and the benefit of continuous measurement for colonoscopists with high ADR is unclear. We examined the ADR trends at our center to determine whether continuous measurement for consistently high ADR is warranted. Methods Among colonoscopies performed between January 1999 and November 2019 at a tertiary center, we analyzed data from colonoscopists performing at least 50 screening colonoscopies annually for 5 consecutive years. ADR trends for individual colonoscopists were examined using Joinpoint regression models. Results Eleven colonoscopists performed screening colonoscopies on 14,047 patients, and 5,912 among them had at least 1 conventional adenoma removed (42.0%). Of 25,829 polyps, 13,585 (52.6%) were conventional adenomas or adenocarcinomas and contributed to ADR calculation. All but 1 colonoscopist included met the recommended minimum threshold ADR of 25% continuously over the study period. Of the 11 colonoscopists, 5 had an increase in their ADR and the remaining 6 had stable ADRs over the study period. Conclusion For colonoscopists consistently performing above the minimum threshold, diversion of resources toward improvement of quality measures other than ADR is justified