Clinical outcomes of the “resect and discard” strategy using magnifying narrow-band imaging for small (< 10 mm) colorectal polyps

• Main Authors: Shigetsugu Tsuji, Yasuhito Takeda, Kunihiro Tsuji, Naohiro Yoshida, Kenichi Takemura, Shinya Yamada, Hisashi Doyama
• Format: Article
• Language: English
• Published: Georg Thieme Verlag KG 2018-11-01
• Series: Endoscopy International Open
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/a-0650-4362

Background and study aim The “resect and discard” strategy is a new paradigm for the management of small colorectal polyps that reduces the cost and effort related to pathological diagnosis after polypectomy. This retrospective study aimed to clarify the clinical outcome of the “resect and discard” strategy for small colorectal polyps. Patients and methods The clinical records were reviewed from 501 consecutive patients who underwent the “resect and discard” strategy for colorectal polyps smaller than 10 mm at our hospital between January 2008 and December 2010. All colorectal lesions were evaluated onsite under magnifying narrow-band imaging after careful conventional white-light imaging. In cases of low grade adenoma predicted with high confidence, colonoscopists selected the “resect and discard” option without formal histopathology. The mid-term outcomes were evaluated to validate the curability of the “resect and discard” strategy. Results The present study included 501 consecutive patients with 816 lesions. The mid-term outcomes were examined for 476 (95 %) patients who received follow-up for at least 1 year after undergoing the “resect and discard” strategy. The median observation period was 83 months (range 12 – 117 months). No patient died from colorectal cancer related to the procedure, resulting in a disease-specific survival rate of 100 %. There were no local and/or distant recurrences detected during follow-up. Conclusions The “resect and discard” strategy for small colorectal polyps under strict preoperative diagnosis achieves excellent mid-term outcome.