Frequency of errors in colorectal lesion description and management prior to referral to a tertiary center

Yervant Ichkhanian; Rachel E Lahr; John J Guardiola; Douglas K Rex

doi:10.1016/j.gie.2024.10.056

Frequency of errors in colorectal lesion description and management prior to referral to a tertiary center

Gastrointest Endosc. 2024 Oct 29:S0016-5107(24)03668-X. doi: 10.1016/j.gie.2024.10.056. Online ahead of print.

Authors

Yervant Ichkhanian¹, Rachel E Lahr¹, John J Guardiola¹, Douglas K Rex¹

Affiliation

¹ Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.

PMID: 39481578
DOI: 10.1016/j.gie.2024.10.056

Abstract

Background and aims: Accurate reporting of polyp characteristics is crucial for effective resource allocation in endoscopic resection referrals. We present our experience with prereferral management of challenging colorectal lesions.

Methods: We reviewed a prospectively collected database of consecutive referrals for endoscopic resection of challenging colorectal lesions. The database included details of prior colonoscopies. We assessed prereferral management using established guidelines.

Results: Among 1826 referred lesions in 1508 patients, size estimates were missing for 421 (24%) lesions; 56 (3.2%) were twice as large as previously estimated, and 65 (3.7%) were half the previous estimate. Morphologic descriptions were absent for 376 (22%) polyps. Tattooing was performed for 822 (47%) lesions, with 195 (24%) placed correctly. Of the 872 (61%) polyps that underwent biopsy, only 11 (1.3%) were classified high risk by the referring endoscopist.

Conclusions: Errors in prereferral management of challenging colorectal lesions are frequent. Improved adherence to national guidelines could enhance practice.